Outcome of extrapleural pneumonectomy for malignant pleural mesothelioma

Abstract

Objective. The aim of this study was to determine the significance of extrapleural pneumonectomy for malignant pleural mesothelioma. A retrospective study was performed on its surgical outcomes and prognostic factors. Subjects. The subjects were 32 patients in whom our research group performed extrapleural pneumonectomy. Results. The patients were 31 men and 1 woman. Their mean age was 55.4 years old. The incidence of postoperative complications was 56.3% which included empyema and detachment of a reconstruction patch for the diaphragm. There were 2 operative deaths (6.3%). Combination therapy was performed in 13 patients (40.6%) including intrathoracic perfusion chemohyperthermia and systemic chemotherapy. The postoperative 2- and 3-year cumulative survival rates among all patients were 40.1% and 16.0%, respectively. The median survival time was 16.2 months. The multivariate analysis on prognostic factors indicated that the following were 3 significant independent factors for good prognosis: an Eastern Cooperative Oncology Group Performance Status of 0, N0, and operative time < 600 minutes. The 2- and 3-year survival rates of patients satisfying all 3 factors were 64.8% and 51.9%, respectively. Conclusion. Extrapleural pneumonectomy for malignant pleural mesothelioma can be expected to have a relatively good prognosis by appropriate patient selection. © 2009 The Japan Lung Cancer Society.