gms | German Medical Science

Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie

24.-26.10.2013, Basel, Schweiz

Treatment and survival of patients with malignant pleural mesothelioma

Meeting Abstract

  • A. E. Frick - Thoraxchirurgie, Otto Wagner Spital, Wien
  • E. Stubenberger - Thoraxchirurgie, Otto Wagner Spital, Wien
  • F. Posch - Thoraxchirurgie, Otto Wagner Spital, Wien
  • B. Jank - Thoraxchirurgie, Otto Wagner Spital, Wien
  • M. R. Müller - Thoraxchirurgie, Otto Wagner Spital, Wien
  • M. Hochmair - 1. Interne Lungenabteilung, Otto Wagner Spital, Wien
  • S. B. Watzka - Thoraxchirurgie, Otto Wagner Spital, Wien

Deutsche Gesellschaft für Thoraxchirurgie. Österreichische Gesellschaft für Thoraxchirurgie. Schweizerische Gesellschaft für Thoraxchirurgie. Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie. Basel, Schweiz, 24.-26.10.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocS7.5

doi: 10.3205/13dgt061, urn:nbn:de:0183-13dgt0615

Published: October 14, 2013

© 2013 Frick et al.
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Outline

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Objective: Malignant pleural mesothelioma (MPM) is a rare neoplastic disorder arising from the mesothelial or sub-mesothelial cells and is associated with asbestos exposure. Its incidence is expected to increase in the next few years. The optimal combination of therapy modalities is not yet established, since the results of most published therapy trials remain poor. According to the literature the current median survival reaches from 9 – 26.3 months. Here we report our institutional experience with MPM.

Methods: A retrospective analysis of all patients with MPM treated in the Division of Thoracic Surgery at the Otto Wagner Hospital in Vienna since January 2007. A total of 35 (28 male; 7 female) patients with a median age of 61 years (range, 45–80 years) at time of MPM diagnosis were examined for this study. Survival and prognostic factors were analyzed by univariate and multivariate statistical analysis.

Results: Out of the population of 35 patients, 30 patients (86%) had an epitheloid subtype. At the time of MPM diagnosis, the majority (69%) of patients were in an advanced stage of disease (Stage III+IV). Of the 35 patients, 33 (91%) received chemotherapy, and 8 (23%) received radiotherapy. All underwent at least one surgical procedure: extrapleural pneumonectomy (n=5, 14%), lung-saving radical surgery (n=26, 74%), or palliative measures (n=4, 12%). After a median follow-up time of 25.92 months (CI: 15.36–40.68), the overall survival rate was 49% (n=17). The overall median survival time was 21.24 months. There was no significantly difference (log rank p=0.32) in overall median survival between the 2 cohorts [Cohort I (Stage I/II) n=11, 29.88 months, Cohort II (Stage III/IV) n=24, 20.4 months]. Patients had a significantly (p<0.001) better median survival with an epitheloid subtype (23.28 months) compared to non-epitheloid subtypes (12 months). As predictive survival factors only the non-epitheloid subtype (hazard ratio: 20.5, p=0.008) and positive N2 status (Hazard ratio=4.1, p=0.05) had a significant influence.

Conclusion: Our retrospective analysis confirms the generally poor prognosis of MPM. However, in comparison with the literature, our survival results seem to compare favorably with the best published results.