Document Detail


Patterns of failure after trimodality therapy for malignant pleural mesothelioma.
MedLine Citation:
PMID:  9033296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Malignant pleural mesothelioma is uncommon, and presently, no standard treatment of this disease exists. The objective of our analysis was to study the patterns of failure for malignant pleural mesothelioma after trimodality treatment consisting of extrapleural pneumonectomy, chemotherapy, and radiation therapy. METHODS: Between 1987 and 1993, 49 patients with malignant pleural mesothelioma underwent extrapleural pneumonectomy. There were two perioperative deaths, and 1 patient died 5 weeks after extrapleural pneumonectomy. Thirty-five of the surviving patients received adjuvant chemotherapy (32/35 received cyclophosphamide, doxorubicin, and cisplatin) followed by hemithorax radiation therapy. Ten patients received chemotherapy but no radiation therapy, and 1 patient received no adjuvant therapy. Median follow-up time for the 23 living patients from the date of operation was 18 months. RESULTS: Of the 46 evaluable patients, 25 had recurrence (54%), with a median time to first failure of 19 months (range, 5 to 51 months). The sites of first recurrence were local in 35% of patients, abdominal in 26%, the contralateral thorax in 17%, and other distant sites in 8%. (Some patients had recurrence in multiple sites simultaneously.) CONCLUSIONS: The most common site of failure after trimodality therapy was the ipsilateral hemithorax. Isolated distant failures were uncommon. Future strategies should investigate methods of enhancing local tumor control.
Authors:
E H Baldini; A Recht; G M Strauss; M M DeCamp; S J Swanson; M J Liptay; S J Mentzer; D J Sugarbaker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  63     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-03-13     Completed Date:  1997-03-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  334-8     Citation Subset:  AIM; IM    
Affiliation:
Joint Center for Radiation Therapy, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Neoplasms / secondary
Adult
Aged
Chemotherapy, Adjuvant
Female
Humans
Male
Mesothelioma / mortality,  secondary,  surgery*
Middle Aged
Neoplasm Recurrence, Local*
Pleural Neoplasms / mortality,  pathology,  surgery*
Pneumonectomy*
Radiotherapy, Adjuvant
Survival Analysis
Thoracic Neoplasms / secondary
Treatment Failure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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