Skip to main content
SpringerLink
Log in

Post-recurrence chemotherapy for mesothelioma patients undergoing extrapleural pneumonectomy

  • Original Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

Additional chemotherapy is often not feasible in patients with recurrent malignant pleural mesothelioma (MPM) undergoing extrapleural pneumonectomy (EPP), due to deteriorated cardiopulmonary reserve. We thus examined the feasibility and efficacy of additional chemotherapy in patients with recurrent MPM after EPP.

Methods

A retrospective review was conducted of 59 consecutive patients who underwent bi-/tri-modal treatment with induction chemotherapy, EPP, and radiation therapy from July 2004 to August 2013 at Hyogo College of Medicine (Nishinomiya, Japan).

Results

Of 59 patients, 39 (male/female = 31/8, right/left = 15/24, pathological stage I/II/III/IV = 1/7/23/3, bi-/tri-modality = 27/12) relapsed at a median age of 62 (range 37–71) years. The median time to recurrence after EPP was 11.6 months. Of the 39 relapsed patients, 12 received best supportive care alone, six started but discontinued chemotherapy, and the remaining 21 (53%) completed more than three cycles of intravenous chemotherapy. The median survival time after EPP was significantly longer in 21 patients who received additional chemotherapy than in 18 patients who did not (39.2 vs. 12.2 months, P = 0.009).

Conclusions

Additional systemic chemotherapy was successfully administered in more than 50% of relapsed patients after bi-/tri-modal treatment, which included EPP, and resulted in a longer survival in comparison with best supportive care alone.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Rice D, Rusch V, Pass H et al. (2011) Recommendations for uniform definitions of surgical techniques for malignant pleural mesothelioma: a consensus report of the international association for the study of lung cancer international staging committee and the international mesothelioma interest group. J Thorac Oncol 6(8):1304–1312. doi:10.1097/JTO.0b013e3182208e3f

    Article  PubMed  Google Scholar 

  2. Lang-Lazdunski L, Bille A, Lal R et al. (2012) Pleurectomy/decortication is superior to extrapleural pneumonectomy in the multimodality management of patients with malignant pleural mesothelioma. J Thorac Oncol 7(4):737–743. doi:10.1097/JTO.0b013e31824ab6c5

    Article  PubMed  Google Scholar 

  3. Cao C, Tian D, Park J et al. (2014) A systematic review and meta-analysis of surgical treatments for malignant pleural mesothelioma. Lung Cancer 83(2):240–245. doi:10.1016/j.lungcan.2013.11.026

    Article  PubMed  Google Scholar 

  4. Lang-Lazdunski L (2014) Surgery for malignant pleural mesothelioma: why, when and what? Lung Cancer 84(2):103–109. doi:10.1016/j.lungcan.2014.01.021

    Article  PubMed  Google Scholar 

  5. Rena O, Casadio C (2012) Extrapleural pneumonectomy for early stage malignant pleural mesothelioma: an harmful procedure. Lung Cancer. doi:10.1016/j.lungcan.2011.12.009

    Google Scholar 

  6. de Perrot M, Feld R, Cho BC et al. (2009) Trimodality therapy with induction chemotherapy followed by extrapleural pneumonectomy and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma. J Clin Oncol 27(9):1413–1418. doi:10.1200/JCO.2008.17.5604

    Article  PubMed  Google Scholar 

  7. Jassem J, Ramlau R, Santoro A et al. (2008) Phase III trial of pemetrexed plus best supportive care compared with best supportive care in previously treated patients with advanced malignant pleural mesothelioma. J Clin Oncol 26(10):1698–1704. doi:10.1200/jco.2006.09.9887

    Article  CAS  PubMed  Google Scholar 

  8. Baldini EH, Recht A, Strauss GM et al. (1997) Patterns of failure after trimodality therapy for malignant pleural mesothelioma. Ann Thorac Surg 63(2):334–338

    Article  CAS  PubMed  Google Scholar 

  9. Hasegawa S (2014) Extrapleural pneumonectomy or pleurectomy/decortication for malignant pleural mesothelioma. Gen Thorac Cardiovasc Surg. doi:10.1007/s11748-014-0389-7

    PubMed  PubMed Central  Google Scholar 

  10. Treasure T, Lang-Lazdunski L, Waller D et al. (2011) Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma: clinical outcomes of the Mesothelioma and Radical Surgery (MARS) randomised feasibility study. Lancet Oncol 12(8):763–772. doi:10.1016/s1470-2045(11)70149-8

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hasegawa S, Okada M, Tanaka F et al. (2015) Trimodality strategy for treating malignant pleural mesothelioma: results of a feasibility study of induction pemetrexed plus cisplatin followed by extrapleural pneumonectomy and postoperative hemithoracic radiation (Japan Mesothelioma Interest Group 0601 Trial). Int J Clin Oncol. doi:10.1007/s10147-015-0925-1

    Google Scholar 

  12. Bolukbas S, Manegold C, Eberlein M et al. (2011) Survival after trimodality therapy for malignant pleural mesothelioma: radical pleurectomy, chemotherapy with cisplatin/pemetrexed and radiotherapy. Lung Cancer 71(1):75–81. doi:10.1016/j.lungcan.2009.08.019

    Article  PubMed  Google Scholar 

  13. Gomez DR, Hong DS, Allen PK et al. (2013) Patterns of failure, toxicity, and survival after extrapleural pneumonectomy and hemithoracic intensity-modulated radiation therapy for malignant pleural mesothelioma. J Thorac Oncol 8(2):238–245. doi:10.1097/JTO.0b013e31827740f0

    Article  PubMed  Google Scholar 

  14. Vogelzang NJ, Rusthoven JJ, Symanowski J et al. (2003) Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 21(14):2636–2644. doi:10.1200/JCO.2003.11.136

    Article  CAS  PubMed  Google Scholar 

  15. Manegold C, Symanowski J, Gatzemeier U et al. (2005) Second-line (post-study) chemotherapy received by patients treated in the phase III trial of pemetrexed plus cisplatin versus cisplatin alone in malignant pleural mesothelioma. Ann Oncol 16(6):923–927. doi:10.1093/annonc/mdi187

    Article  CAS  PubMed  Google Scholar 

  16. Gerbaudo VH, Mamede M, Trotman-Dickenson B et al. (2011) FDG PET/CT patterns of treatment failure of malignant pleural mesothelioma: relationship to histologic type, treatment algorithm, and survival. Eur J Nucl Med Mol Imaging 38(5):810–821. doi:10.1007/s00259-010-1704-x

    Article  PubMed  Google Scholar 

  17. Kostron A, Friess M, Crameri O et al. (2015) Relapse pattern and second-line treatment following multimodality treatment for malignant pleural mesotheliomadagger. Eur J Cardiothorac Surg. doi:10.1093/ejcts/ezv398

    Google Scholar 

Download references

Acknowledgements

The authors would like to thank Enago (www.enago.jp) for the English language review.

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo, 663-8501, Japan

    Teruhisa Takuwa, Masaki Hashimoto, Seiji Matsumoto, Nobuyuki Kondo & Seiki Hasegawa

  2. Department of Respiratory Medicine, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo, Japan

    Kozo Kuribayash & Takashi Nakano

Authors
  1. Teruhisa Takuwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masaki Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seiji Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nobuyuki Kondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kozo Kuribayash
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takashi Nakano
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seiki Hasegawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Teruhisa Takuwa.

Ethics declarations

Funding

None declared.

Conflict of interest

All authors have declared no conflicts of interest.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Takuwa, T., Hashimoto, M., Matsumoto, S. et al. Post-recurrence chemotherapy for mesothelioma patients undergoing extrapleural pneumonectomy. Int J Clin Oncol 22, 857–864 (2017). https://doi.org/10.1007/s10147-017-1126-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10147-017-1126-x

Keywords

Search

Navigation