HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rice, T. W. Articles by Weick, J. K. Search for Related Content PubMed PubMed Citation Articles by Rice, T. W. Articles by Weick, J. K.

The Annals of Thoracic Surgery, Vol 58, 24-29, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Aggressive multimodality therapy for malignant pleural mesothelioma

TW Rice, DJ Adelstein, TJ Kirby, MG Saltarelli, SR Murthy, MA Van Kirk, HP Wiedemann and JK Weick
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Ohio 44195.

Nineteen patients with clinical stage I malignant pleural mesothelioma were treated with aggressive multimodality therapy. Nine patients underwent pleurectomy and decortication followed by immediate intrapleural chemotherapy with cisplatin and mitomycin C. Ten patients required pleuropneumonectomy followed within 1 week to 2 weeks by intrapleural administration of cisplatin (100 mg). Four to 8 weeks after operation, 15 patients underwent postoperative adjuvant cisplatin- based systemic chemotherapy. There were three postoperative complications (16%) requiring reoperation and one postoperative death (5%). Intrapleural chemotherapy was well tolerated with no complications. Systemic chemotherapy was poorly tolerated, and there was one chemotherapy-related death. Sixteen patients (84%) experienced good to excellent palliation. Three patients are currently alive with no evidence of recurrent disease at 10, 35, and 43 months. The median overall survival was 13 months and the median disease-free survival, 11 months. Overall and disease-free 3-year survivals were 17% and 22%, respectively. Patients with epithelial malignant pleural mesothelioma had significantly better overall survival (p = 0.037) and disease-free survival (p = 0.02) than patients with sarcomatous or biphasic malignant pleural mesothelioma. We conclude that despite major toxicity, in select patients with clinical stage I malignant pleural mesothelioma, aggressive multimodality therapy offers effective palliation and occasional long-term disease-free survival.

This article has been cited by other articles:

				B. Melloni, J. Monteil, F. Vincent, F. Bertin, S. Gaillard, T. Ducloux, S. Verbeke, A. Maubon, J-C. Vandroux, and F. Bonnaud Assessment of 18F-fluorodeoxyglucose dual-head gamma camera in asbestos lung diseases Eur. Respir. J., November 1, 2004; 24(5): 814 - 821. [Abstract] [Full Text] [PDF]

				M. Pistolesi and J. Rusthoven Malignant Pleural Mesothelioma: Update, Current Management, and Newer Therapeutic Strategies Chest, October 1, 2004; 126(4): 1318 - 1329. [Abstract] [Full Text] [PDF]

				D. J. Stewart, A. Martin-Ucar, J. E. Pilling, J. G. Edwards, K. J. O'Byrne, and D. A. Waller The effect of extent of local resection on patterns of disease progression in malignant pleural mesothelioma Ann. Thorac. Surg., July 1, 2004; 78(1): 245 - 252. [Abstract] [Full Text] [PDF]

				S. van Ruth, P. Baas, and F. A. N. Zoetmulder Surgical Treatment of Malignant Pleural Mesothelioma: A Review Chest, February 1, 2003; 123(2): 551 - 561. [Abstract] [Full Text] [PDF]

				T. Aziz, A. Jilaihawi, and D. Prakash The management of malignant pleural mesothelioma; single centre experience in 10 years Eur. J. Cardiothorac. Surg., August 1, 2002; 22(2): 298 - 305. [Abstract] [Full Text] [PDF]

				V. W. Rusch, K. Rosenzweig, E. Venkatraman, L. Leon, A. Raben, L. Harrison, M. S. Bains, R. J. Downey, and R. J. Ginsberg A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma J. Thorac. Cardiovasc. Surg., October 1, 2001; 122(4): 788 - 795. [Abstract] [Full Text] [PDF]

				D. B. Schneider, C. Clary-Macy, S. Challa, K. C. Sasse, S. H. Merrick, R. Hawkins, G. Caputo, and D. Jablons Positron emission tomography with f18-fluorodeoxyglucose in the staging and preoperative evaluation of malignant pleural mesothelioma J. Thorac. Cardiovasc. Surg., July 1, 2000; 120(1): 128 - 133. [Abstract] [Full Text] [PDF]

				D. B. Campbell Malignant Mesothelioma Ann. Thorac. Surg., May 1, 1997; 63(5): 1503 - 1505. [Full Text]