Abstract 622P
Background
Results of the MARS 2 trial showed high mortality and morbidities in patients who underwent pleurectomy and decortication (P/D) for malignant mesothelioma. A large proportion of the reported cases were, however, extended P/D. P/D without diaphragmatic resection had been routinely performed in our institution on selected patients with malignant mesothelioma and we aimed to review our outcomes of patients who underwent P/D versus those who underwent extended P/D.
Methods
This is a retrospective cohort study of all the patients in our institution over a 10 year period who underwent either extended P/D or limited P/D. Patients with epitheloid pathology were included, while those with mixed/biphasic/sacromatoid, as well as those underwent extrapleural pneumonectomy were excluded. All patients will continue to undergo adjuvant chemotherapy +/- radiotherapy as indicated as part of their multi-modality treatment depending on their overall fitness post-surgery.
Results
26 patients underwent surgery for malignant mesothelioma. 20 patients were included into the study after meeting the criteria. There was no significant difference in age, gender and race for patients who underwent limited vs extensive P/D. All patients needing extensive P/D required open surgery while 84.6% of limited P/D were performed via minimally invasive uniportal VATS. Limited P/D patients had significantly shorter duration of operation and amount of blood loss. Post op length of stay for limited P/D patients is also shorter but not statistically significant. The mean duration of follow up for all patients 27.7 +/- 6.4 months. Limited P/D patients (34.95 +/- 8.30 months) had significantly higher mean overall survival (OS) than extensive P/D patients (12.34 +/- 2.38 months) (p = 0.048).
Conclusions
Our study demonstrated that limited P/D without diaphragm or lung resection may still be of clinical benefit and should be considered and further evaluated for patients with malignant mesothelioma especially of the epitheloid subtype.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.