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Poster Display session

135P - Macroscopic complete resection versus non-surgical management for malignant pleural mesothelioma


31 Mar 2023


Poster Display session


Asmaa Ellaithy


Journal of Thoracic Oncology (2023) 18 (4S): S116-S118.


A. Ellaithy

Author affiliations

  • Ismailia/EG


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Abstract 135P


Malignant pleural mesothelioma is a rare aggressive tumor originating from the pleural mesothelial cells with average survival of 12 months. Primary chemoradiotherpy, surgery with or without adjuvant chemo(radio)therapy are different treatment modalities. However, there is only one small randomized controlled trial discussed the role of surgery versus non-surgical management for malignant pleural mesothelioma. So this study aims to evaluate the impact of macroscopic complete resection versus non-surgical management on survival outcome to provide additional evidence for better management for pleural mesothelioma.


Data of 4233 patient was extracted with Surveillance, Epidemiology and End Results (SEER) program software, all of them had malignant pleural mesothelioma and diagnosed from 2000 to 2019. They were divided into two subgroups; a group had macroscopic complete surgical resection and a group had non-surgical management with further stratification for both groups by the systemic therapy received. We used SPSS 23 for data analysis. Kaplan-Meier curve, Log-rank test for survival analysis.


The 3-year and 5-year overall relative survival for malignant pleural mesothelioma was 13.7% and 7.4%. The 5-year overall survival for macroscopic surgical resection with and without adjuvant therapy was 16.8% and 8% while for non-surgical management with and without systemic therapy was 5.3% and 5.7%; P > 0.0001. Performing COX-regression model; Sex, stage, age and systemic chemo(radio)therapy are significant survival predictors (P > 0.0001).


Malignant pleural mesothelioma had a very poor survival outcome. However, macroscopic complete resection increased the survival about three folds than non-surgical management. Systemic chemo(radio)therapy improved the overall survival after surgical resection while it had no survival benefit in the non-surgical management. Among all treatment modalities, adjuvant radiotherapy had survival benefit of 17% over surgery without systemic therapy. These results highlight surgical resection with adjuvant radiotherapy as the modality of choice after consideration of the age, sex and stage in final evaluation.

Legal entity responsible for the study

The author.


Has not received any funding.


The author has declared no conflicts of interest.

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