Current status of multi-modality treatment for malignant pleural mesothelioma in Japan

Abstract

Background. We investigated the current status of multi-modality treatment for malignant pleural mesothelioma in Japan as part of the campaign entitled "Comprehensive Strategy Against Asbestos-related Diseases", which was funded by the 2006 Special Coordination Fund for Promoting Science and Technology from the Japan Science and Technology Agency. Methods. We evaluated cases of extrapleural pneumonectomy (EPP) for malignant pleural mesothelioma between January 2002 and December 2006. A questionnaire was sent to a total of 69 institutions, and was returned by 61 of them. Results. A total of 171 patients underwent EPP for malignant pleural mesothelioma during the study period. They consisted of 154 males and 17 females, and the age ranged between 14 and 78 with the average of 59. The side of EPP was on the right in 91 and on the left in 80 cases. One postoperative death due to interstitial pneumonia and 6 in-hospital deaths due to tumor recurrence (n = 4), MRSA empyema (n = 1), and pulmonary infarction (n = 1) were noted. Preoperative chemotherapy with cisplatin was given in 38 patients, and 12 out of 38 underwent postoperative hemithorax radiation therapy. The median survival was 23 months. Conclusions. The present study showed an increase of cases and also improvement of surgical mortality of EPP for malignant pleural mesothelioma in comparison with former studies. However, we still do not have clinical evidence regarding the feasibility of multi-modality treatment for malignant pleural mesothelioma. © 2008 The Japan Lung Cancer Society.