Mesothelioma Study Further Confirms Use of Multimodality Therapy

Researchers out of the United Kingdom have reported on their 30-year surgical experience with malignant pleural mesothelioma, finding multimodality therapy combining surgery, chemotherapy and radiation to be most effective at prolonging mesothelioma prognosis.

During the period of the study, a total of 139 patients underwent surgical treatment and their progress was followed. The mean age of the participants was 58.9 years and 87% were males. Two-thirds of the participants exhibited disease on the right side of the body, which is common in pleural malignant mesothelioma.

The surgical procedures included extra-pleural pneumonectomy (EPP) for Butchart stage I patients or pleurectomy/decortication (PD) for patients with more advanced stage diagnosis. Following surgery, some participants underwent post-operative adjuvant therapy. This therapy included either chemotherapy, radiotherapy or both.

The longest survival median of 26 months occurred in the patients who received a pleurectomy/decortication and post-operative therapy with both chemotherapy and radiotherapy. Patients who underwent EPP experienced the most post-operative complications, particularly immediate post-operative infections and broncho-pleural fistulas.

Researchers noted that the EPP surgical procedure “whether or not combined with adjuvant therapy provided no significant survival advantage in comparison to pleurectomy/decortication.” And after univariate analysis (analysis that explores each variable separately), the strongest predictor of prolonged survival was the treatment approach combining pleurectomy/decortication, chemotherapy and radiation.

Patients with an epithelial mesothelioma diagnosis also experienced better survival. Results showed the stage at diagnosis did not influence long-term survival in this particular study.

Upon analyzing the results, the researchers concluded that “cytoreductive surgery combined with post-operative adjuvant therapy provided better survival despite either advanced disease or surgically less fit patients. Thus, pleurectomy/decortication may be the procedure of choice, given that neither surgical procedure (EPP or PD) is not curative.”

Additional information about mesothelioma and treatment options may be found through the Mesothelioma Center.

This entry was posted on Wednesday, December 16th, 2009 at 1:59 pm and is filed under Mesothelioma, Mesothelioma Research, Mesothelioma Treatment. You can follow any responses to this entry through the RSS feed. Responses are currently closed, but you trackback from your own site.