Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma

For all items and scales, we considered a change of ‡8 points as clinically significant

W. Weder

2007

Scholarcy highlights

  • The aim of this multicenter trial was to prospectively evaluate neo-adjuvant chemotherapy followed by extrapleural pneumonectomy and radiotherapy, including quality of life as outcome
  • Neo-adjuvant chemotherapy consisted of three cycles of cisplatin and gemcitabine followed by EPP
  • The response rate was 32% and 16 patients underwent EPP with no perioperative mortality and the median survival of all patients was 23 months. The aim of this trial SAKK 17/00 was to prospectively evaluate neo-adjuvant chemotherapy followed by EPP with or without radiotherapy in a multicenter setting in Switzerland
  • Eligibility criteria Patients were eligible for the trial if they had a histologically confirmed diagnosis of malignant pleural mesothelioma, including all subtypes and clinical T1–T3, N0–2, M0 disease considered to be completely resectable as evaluated by a thoracic oncology tumor board including a thoracic surgeon
  • For the 45 patients undergoing EPP the estimated median survival was 23 months
  • While combination chemotherapy with a platin compound and a folate antagonist is the recommended treatment of patients with advanced disease, our results indicate that patients with potentially operable MPM can be offered the benefit of a more radical multimodality approach including neo-adjuvant chemotherapy and EPP without major long-term impairment on their quality of life, if the treatment is carried out by an experienced team
  • While combination chemotherapy with a platin compound and a folate antagonist is the recommended treatment of patients with advanced disease, our results indicate that patients with potentially operable malignant pleural mesothelioma can be offered the benefit of a more radical multimodality approach including neo-adjuvant chemotherapy and extrapleural pneumonectomy without major long-term impairment on their quality of life, if the treatment is carried out by an experienced team

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