Extrapleural pneumonectomy followed by intracavitary intraoperative hyperthermic cisplatin with pharmacologic cytoprotection for treatment of malignant pleural mesothelioma: A phase II prospective study

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Tamara R. Tilleman

2009

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  • Patients with malignant pleural mesothelioma who were surgical candidates underwent extrapleural pneumonectomy followed by hyperthermic intraoperative intracavitary cisplatin perfusion, consisting of a 1-hour lavage of the chest and abdomen with cisplatin at 225 mg/m2
  • Hyperthermic intraoperative intracavitary cisplatin perfusion following extrapleural pneumonectomy can be performed with acceptable morbidity and mortality
  • 92 patients completed hyperthermic intraoperative chemotherapy treatment according to the protocol
  • Included a low incidence of initial recurrence in the ipsilateral hemithorax and a concomitant high incidence of recurrence in the contralateral hemithorax and abdomen, which remains a fatal problem for patients who have undergone pneumonectomy and highlights the need for improved systemic therapies for MPM once local control has been achieved
  • The present prospective phase II study establishes that HIOC after EPP can be performed with acceptable morbidity and mortality compared with previous studies that report similar numbers
  • The surgical treatment of MPM was initially limited by unacceptable morbidity and mortality for complete resection

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