Department of Surgery, University of California, San Francisco, Oakland, California.
Department of Surgery, University of California, San Francisco, Oakland, California.
Ann Thorac Surg. 2022 Nov;114(5):e357-e359. doi: 10.1016/j.athoracsur.2022.01.011. Epub 2022 Jan 31.
A 78-year old man presenting with epithelial malignant pleural mesothelioma (MPM) underwent multidisciplinary review at our institution. We offered surgical resection with adjuvant chemotherapy, but the patient declined. After 6 months, his disease progressed, and he opted for dual immunotherapy with ipilimumab and nivolumab; however, pneumonitis developed after treatment initiation. Immunosuppression controlled the pneumonitis, but his MPM progressed, so salvage surgical resection was offered. Left extrapleural pneumonectomy was successfully performed with an unremarkable recovery. Final pathology revealed stage III biphasic mesothelioma. This report demonstrates the feasibility of salvage resection for progression of MPM after immunotherapy.
一位 78 岁男性，患有上皮性恶性胸膜间皮瘤（MPM），在我院进行了多学科评估。我们建议他进行手术切除联合辅助化疗，但患者拒绝了。6 个月后，他的病情进展，选择接受伊匹单抗和纳武单抗联合免疫治疗；然而，治疗开始后出现了肺炎。免疫抑制控制了肺炎，但他的 MPM 仍在进展，因此我们建议进行挽救性手术切除。左开胸胸膜外肺切除术顺利完成，恢复良好。最终病理显示为 III 期双相性间皮瘤。本报告证明了免疫治疗后 MPM 进展时进行挽救性切除的可行性。
