Cytoreductive surgery combined with intraoperative hyperthermic intrathoracic chemotherapy for stage I malignant pleural mesothelioma
(2003) In Annals of Surgical Oncology 10(2). p.176-182- Abstract
BACKGROUND: Malignant pleural mesothelioma (MPM) is a disease mostly confined to the thoracic cavity. Untreated, the median survival is <1 year. Cytoreductive surgery combined with intraoperative hyperthermic intrathoracic chemotherapy is used to kill residual tumor cells on the surface of the thoracic cavity while having limited systemic side effects.
METHODS: From August 1998 to August 2001, 22 patients with stage I MPM were included in this study. Two patients were irresectable at operation because of extrathoracic tumor growth. Twenty procedures were performed. After cytoreduction, a perfusion was performed with cisplatin and doxorubicin at 40 degrees C to 41 degrees C for 90 minutes. Adjuvant radiotherapy was given to... (More)
BACKGROUND: Malignant pleural mesothelioma (MPM) is a disease mostly confined to the thoracic cavity. Untreated, the median survival is <1 year. Cytoreductive surgery combined with intraoperative hyperthermic intrathoracic chemotherapy is used to kill residual tumor cells on the surface of the thoracic cavity while having limited systemic side effects.
METHODS: From August 1998 to August 2001, 22 patients with stage I MPM were included in this study. Two patients were irresectable at operation because of extrathoracic tumor growth. Twenty procedures were performed. After cytoreduction, a perfusion was performed with cisplatin and doxorubicin at 40 degrees C to 41 degrees C for 90 minutes. Adjuvant radiotherapy was given to surgical scars and drainage tracts.
RESULTS: There was no perioperative mortality, but significant morbidity was seen in 13 patients (65%), including bronchopleural fistula, diaphragm rupture, wound dehiscence, persistent air leakage, and chylous effusion. No hair loss or leucopenia was noticed. The median follow-up was 14 months. The median survival (Kaplan-Meier) was 11 months, with a 1-year survival of 42%. A favorable pharmacokinetic ratio was observed for both cisplatin and doxorubicin.
CONCLUSIONS: Cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy for stage I MPM is feasible. However, this treatment is accompanied by considerable morbidity. Survival data were less encouraging.
(Less)
- author
- van Ruth, S ; Baas, P ; Haas, R L M ; Rutgers, E J Th ; Verwaal, V J LU and Zoetmulder, F A N
- publishing date
- 2003
- type
- Contribution to journal
- publication status
- published
- keywords
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Cisplatin/administration & dosage, Combined Modality Therapy, Doxorubicin/administration & dosage, Female, Humans, Hyperthermia, Induced, Intraoperative Period, Male, Mesothelioma/drug therapy, Middle Aged, Neoplasm Recurrence, Local, Pleural Neoplasms/drug therapy, Radiotherapy, Adjuvant, Survival Analysis, Treatment Outcome
- in
- Annals of Surgical Oncology
- volume
- 10
- issue
- 2
- pages
- 176 - 182
- publisher
- Springer
- external identifiers
-
- scopus:0038283091
- pmid:12620914
- ISSN
- 1068-9265
- DOI
- 10.1245/aso.2003.03.022
- language
- English
- LU publication?
- no
- id
- 9582981b-3458-4594-9446-40df567dbe9a
- date added to LUP
- 2022-04-12 10:52:54
- date last changed
- 2024-03-03 00:35:12
@article{9582981b-3458-4594-9446-40df567dbe9a,
abstract = {{<p>BACKGROUND: Malignant pleural mesothelioma (MPM) is a disease mostly confined to the thoracic cavity. Untreated, the median survival is <1 year. Cytoreductive surgery combined with intraoperative hyperthermic intrathoracic chemotherapy is used to kill residual tumor cells on the surface of the thoracic cavity while having limited systemic side effects.</p><p>METHODS: From August 1998 to August 2001, 22 patients with stage I MPM were included in this study. Two patients were irresectable at operation because of extrathoracic tumor growth. Twenty procedures were performed. After cytoreduction, a perfusion was performed with cisplatin and doxorubicin at 40 degrees C to 41 degrees C for 90 minutes. Adjuvant radiotherapy was given to surgical scars and drainage tracts.</p><p>RESULTS: There was no perioperative mortality, but significant morbidity was seen in 13 patients (65%), including bronchopleural fistula, diaphragm rupture, wound dehiscence, persistent air leakage, and chylous effusion. No hair loss or leucopenia was noticed. The median follow-up was 14 months. The median survival (Kaplan-Meier) was 11 months, with a 1-year survival of 42%. A favorable pharmacokinetic ratio was observed for both cisplatin and doxorubicin.</p><p>CONCLUSIONS: Cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy for stage I MPM is feasible. However, this treatment is accompanied by considerable morbidity. Survival data were less encouraging.</p>}},
author = {{van Ruth, S and Baas, P and Haas, R L M and Rutgers, E J Th and Verwaal, V J and Zoetmulder, F A N}},
issn = {{1068-9265}},
keywords = {{Adult; Aged; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Cisplatin/administration & dosage; Combined Modality Therapy; Doxorubicin/administration & dosage; Female; Humans; Hyperthermia, Induced; Intraoperative Period; Male; Mesothelioma/drug therapy; Middle Aged; Neoplasm Recurrence, Local; Pleural Neoplasms/drug therapy; Radiotherapy, Adjuvant; Survival Analysis; Treatment Outcome}},
language = {{eng}},
number = {{2}},
pages = {{176--182}},
publisher = {{Springer}},
series = {{Annals of Surgical Oncology}},
title = {{Cytoreductive surgery combined with intraoperative hyperthermic intrathoracic chemotherapy for stage I malignant pleural mesothelioma}},
url = {{http://dx.doi.org/10.1245/aso.2003.03.022}},
doi = {{10.1245/aso.2003.03.022}},
volume = {{10}},
year = {{2003}},
}