Zentralbl Chir 2019; 144(S 01): S82
DOI: 10.1055/s-0039-1694172
Vorträge – DACH-Jahrestagung: nummerisch aufsteigend sortiert
Georg Thieme Verlag KG Stuttgart · New York

Cytoreductive surgery and hyperthermic intrathoracic chemoperfusion shows superior overall survival compared to extrapleural pneumonectomy for pleural mesothelioma

L Klotz
1   Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
4   Translational Lung Research Center (TLRC), Heidelberg, Germany; Member of German Center for Lung Research (DZL)
,
C Grünewald
1   Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
,
EL Bulut
1   Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
,
F Eichhorn
1   Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
,
M Thomas
2   Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Heidelberg, Germany
4   Translational Lung Research Center (TLRC), Heidelberg, Germany; Member of German Center for Lung Research (DZL)
,
T Muley
1   Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
,
H Winter
1   Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
4   Translational Lung Research Center (TLRC), Heidelberg, Germany; Member of German Center for Lung Research (DZL)
,
H Hoffmann
3   Division of Thoracic Surgery, Technical University of Munich, Munich, Germany
,
M Eichhorn
1   Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
4   Translational Lung Research Center (TLRC), Heidelberg, Germany; Member of German Center for Lung Research (DZL)
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Publikationsdatum:
04. September 2019 (online)

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    Background:

    The best surgical treatment for malignant pleural mesothelioma is still under debate. Lung sparing cytoreductive surgery by extended pleurectomy and decortication (P/D) combined with hyperthermic intrathoracic chemoperfusion (HITHOC) and followed by additive chemotherapy represents a promising treatment strategy. Aim of the study was to investigate perioperative morbidity of P/D and HITHOC compared to extrapleural pneumonectomy (EPP) within a trimodal treatment approach in a high volume center and to analyze overall survival.

    Methods:

    A standardized P/D and HITHOC procedure was established in 2014. Clinical data of patients with epitheloid pleural mesothelioma treated by P/D and HITHOC or EPP were included in this analysis. To achieve comparable results, patients undergoing EPP within a trimodal treatment approach between 2000 and 2012 were matched by epitheloid subtype and sex. Survival data were analyzed according to Kaplan-Meier. Data are given as mean ± SD.

    Results:

    Between 2014 and 2018, 61 patients with epitheloid pleural mesothelioma were treated by P/D, HITHOC and additive chemotherapy among 53 (87%) were male. Mean age was 66.5 ± 7.9 years. In the cohort matched by tumor subtype and sex, 61 patients with a mean age of 57.7 ± 7.9 years were treated by neoadjuvant chemotherapy, EPP and adjuvant radiotherapy. Median overall survival was 42.2 months in the P/D group compared to 22.4 months for patients undergoing EPP.

    Conclusion:

    P/D and HITHOC appears safe in mesothelioma patients with increased overall survival compared to EPP within a trimodal treatment approach.


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