1561P - Post-recurrence additional chemotherapy is feasible and effective in patients undergoing extrapleural pneumonectomy for malignant pleural mesothelioma

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Surgical Oncology
Biological Therapy
Radiation Oncology
Presenter Teruhisa Takuwa
Citation Annals of Oncology (2014) 25 (suppl_4): iv542-iv545. 10.1093/annonc/mdu357
Authors T. Takuwa1, M. Hashimoto2, A. Kuroda2, S. Matsumoto2, N. Kondo2, T. Nakano3, S. Hasegawa2
  • 1General Thoracic Surgery, Hyogo College of Medicine, 6638501 - Nishinomiya/JP
  • 2Thoracic Surgery, Hyogo College of Medicine, Nishinomiya/JP
  • 3Division Of Respiratory Medicine, Hyogo College of Medicine, JP-663-8501 - Nishinomiya/JP



It is believed that additional chemotherapy is infrequently feasible in patients with recurrent malignant pleural mesothelioma (MPM) after extrapleural pneumonectomy (EPP) due to deteriorated cardiopulmonary reserve. We examined the feasibility and efficacy of additional chemotherapy in patients with recurrent MPM after EPP.


A retrospective review was conducted on 56 consecutive patients who underwent bi-/tri-modality treatment with induction chemotherapy, EPP, and with/without radiation therapy during July 2004 and November 2013 at Hyogo College of Medicine.


Of 56 patients, 31 (M/F=25/6, right/left=11/20, p-stage I/II/III/IV=1/5/22/3, bi-/tri-modality=12/19) relapsed at median age of 60 years (37-70). Median time to recurrence after EPP was 8.9 months. Of 31 relapsed patients, 10 received best supportive care (BSC) alone, 4 started but discontinued chemotherapy and had BSC, and the remaining 17 (55%) completed>3 cycles of intravenous chemotherapy. Median survival time after recurrence was significantly longer in 17 patients who received additional chemotherapy than that in 14 patients who did not (20 months vs. 3.1 months, p=0.001).

Overrall(n=56) Relapsed(n=31)
BSC(n=14) additional chemo(n=17)
M/F 48/8 12/2 14/3
Right/left 26/30 5/9 6/11
Age at recurrence 62(37-71) 63(37-70) 61(44-68)
Time to rucurrence after EPP NA 5.2 mo 24 mo
MST after recurrence NA 3.1 mo 20 mo
MST after EPP 34 mo 9.4 mo 39 mo


Additional systemic chemotherapy was successfully administered in approximately 60% of relapsed patients after bi-/trimodality treatment including EPP, which resulted in a longer survival in comparison with BSC alone.


All authors have declared no conflicts of interest.