197P - Effect of surgical treatment on the survival in patients with malignant pleural mesothelioma.

Date 05 April 2019
Event European Lung Cancer Congress 2019
Topics Mesothelioma
Surgical Oncology
Presenter Renata Baez-Saldana
Citation Annals of Oncology (2019) 30 (suppl_2): ii72-ii73. 10.1093/annonc/mdz069
Authors R. Baez-Saldana1, M.T. Marmolejo-Torres1, M. Iñiguez-García2, J.A. Berrios Mejía2, U. Rumbo-Nava1, O. Arrieta-Rodríguez3
  • 1Respiratory Oncology, Instituto Nacional De Enfermedades Respiratorias, 14080 - Mexico City/MX
  • 2Thoracic Surgery, Instituto Nacional De Enfermedades Respiratorias, 14080 - Mexico City/MX
  • 3Respiratory Oncology, Instituto Nacional de Cancerologia (INCan), 14080 - Mexico City/MX

Abstract

Background

In patients with malignant pleural mesothelioma (MPM) chemotherapy is the only treatment modality that has been shown to improve survival. Surgery, by either pleurectomy/decortication (P/D) or extrapleural pneumonectomy (EPP) can be an option of treatment in patients with early stage disease and good functional status, nevertheless, this modality remains questionable. The aim of this study was to evaluate the effect of surgical treatment on the survival in patients with MPM.

Methods

Case series of patients with histologically proven MPM between January 2012 and Jun 2015 were reviewed retrospectively. The variables analyzed were: age, sex, asbestos exposure, smoking history, biomass exposure, performance status with ECOG scale, staging and type of treatment. Univariate and multivarite analyses were performed using the Cox regression model. Survival functions were estimated using the Kaplan-Meier statistics. The decision to perform either P/D or EPP was on the basis surgeon’s preference.

Results

There were 122 cases of MPM; 71% were males and the media age at diagnosis was 63 years. Twenty (16.4%) of the cases received surgery, 8 EPP, 8 P/D, and 4 were unresectable at the moment of the surgery. The 30-day mortality was 5%, one patient after EPP. The median survival in all cases was 8.6 months, while in the surgical vs no surgical group was 15.8 vs 7.2 months respectively (p < 0.05). In comparision to no surgery treatment, surgery alone was associated with significant improvement in survival [adj HR 0.20 (95%CI: 0.07-0.56). At multivariate analysis independent significant predictors of survival were surgery [adj HR 0.21 (95%CI: 0.06-0.71), beign female [adj HR 0.49 (95%CI: 1.06-4.48), chemotherapy [adj HR 0.22 (95%CI: 0.07-0.70), stage early vs advanced [adj HR 0.47 (95%CI: 0.22-1.04) and ECOG < 2 [adj HR 0.21 (95%CI: 0.06-0.76).

Conclusions

Our data suggest relative advantage of surgery on survival. Patients who received surgery had better survival than patients who were treated with chemotherapy or palliative care alone.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Instituto Nacional de Enfermedades Respiratorias.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.