Ergönül Ayşe Gül, Aydın Sercan, Kahraman Aydın Seda, Akçam Tevfik İlker, Özdil Ali, Turhan Kutsal, Çakan Alpaslan, Çağırıcı Ufuk
Department of Thoracic Surgery, Ege University School of Medicine, Izmir, Türkiye.
Department of Thoracic Surgery, Izmir Democracy University Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Jul 27;31(3):381-387. doi: 10.5606/tgkdc.dergisi.2023.24329. eCollection 2023 Jul.
This study aims to evaluate overall survival, diseasefree survival, and prognostic factors in patients undergoing pleurectomy-decortication and hyperthermic intrathoracic chemotherapy with the diagnosis of malignant pleural mesothelioma.
Between January 2020 and November 2021, a total of 53 patients (27 males, 26 females; mean age: 58.1±1.3 years; range, 39 to 81 years) who underwent pleurectomy-decortication and hyperthermic intrathoracic chemotherapy with the diagnosis of malignant pleural mesothelioma were retrospectively analyzed. Data including characteristics, comorbidities, postoperative complications, recurrence and mortality status of the patients were recorded. Overall survival and disease-free survival and prognostic factors were evaluated.
The median disease-free survival was 11.67 months and the median overall survival was 24.60 months. The median disease-free survival was 8.80 months in men and 13.17 months in women, indicating a statistically significant difference as it showed that recurrence was detected earlier in male patients (p=0.037). The median disease-free survival and overall survival was 6.13 months and 11.70 in cases diagnosed with biphasic mesothelioma, respectively, while it was 11.67 months and 25.46 months in cases with epithelial mesothelioma, respectively. Pathological subtype was found to be an effective prognostic factor for both survival (p=0.049 and p<0.001, respectively).
Hyperthermic intrathoracic chemotherapy following cytoreductive surgery is a preferable and tolerable method in the treatment of malignant pleural mesothelioma. While evaluating surgical indications, it should be kept in mind that cases with epithelial mesothelioma may benefit more from surgical treatment.
本研究旨在评估接受胸膜剥脱术-纤维板剥脱术及胸腔内热化疗的恶性胸膜间皮瘤患者的总生存期、无病生存期及预后因素。
回顾性分析2020年1月至2021年11月期间共53例经诊断为恶性胸膜间皮瘤并接受胸膜剥脱术-纤维板剥脱术及胸腔内热化疗的患者（27例男性，26例女性；平均年龄：58.1±1.3岁；范围39至81岁）。记录患者的特征、合并症、术后并发症、复发及死亡情况。评估总生存期、无病生存期及预后因素。
无病生存期的中位数为11.67个月，总生存期的中位数为24.60个月。男性无病生存期的中位数为8.80个月，女性为13.17个月，差异有统计学意义，表明男性患者复发更早（p=0.037）。双相性间皮瘤患者无病生存期和总生存期的中位数分别为6.13个月和11.70个月，而上皮性间皮瘤患者分别为11.67个月和25.46个月。病理亚型被发现是生存的有效预后因素（分别为p=0.049和p<0.001）。
减瘤手术后的胸腔内热化疗是治疗恶性胸膜间皮瘤的一种可取且可耐受的方法。在评估手术指征时，应牢记上皮性间皮瘤患者可能从手术治疗中获益更多。
