Hwailuh Chang, Jih-Tung Pai, Cho-Yin Lee and Yei-San Hsieh
Background: In Taiwan, the incidence of Malignant Pleural Mesothelioma (MPM) has been increasing over the past three to four decades. This study aimed to analyze the outcomes and overall survival rates in patients undergoing cytoreductive lung-sparing decortication pleurectomy surgery and intraoperative adjuvant therapy (hyperthermic intrathoracic chemotherapy or photodynamic therapy) for malignant pleural mesothelioma at a single center in Taiwan.
Methods: This was a retrospective review of patients who underwent cytoreductive lung-sparing decortication pleurectomy surgery and intraoperative adjuvant therapy for malignant pleural mesothelioma from April 2013 to December 2021.
Results: A total of 17 patients with malignant pleural mesothelioma underwent surgery. There was one case of surgical mortality due to intraoperative uncontrolled bleeding. The subtypes according to histology were epithelioid mesothelioma (58.8%), pleomorphic subtype of epithelioid malignant mesothelioma (5.9%), biphasic mesothelioma (11.8%), and sarcomatoid mesothelioma (23.5%). The median survival was 14.0 months. However, for the epithelioid type, the median survival was 20.0 months.
Conclusion: To our knowledge, this is the first report from a single center in Taiwan devoted to lung-sparing decortication pleurectomy with intraoperative adjuvant therapy for malignant pleural mesothelioma. Although our hospital did the most operations for patients with malignant pleural mesothelioma in Taiwan, we were still far away from being a high-volume center in the world. The outcome is not satisfactory, but still slightly better than that of patients who received chemotherapy alone, especially those with the epithelial subtype disease. One of our patients survived for more than 6 years. We provide an option for the treatment of patients with malignant pleural mesothelioma in Taiwan.
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