Clinical evaluation of treatment for malignant pleural mesothelioma

Abstract

We examined 177 malignant pleural mesothelioma patients treated during a period from 1993 through 2016. Results: Of the 177 patients, 100 patients (56%) received chemotherapy, 52 patients (29%) underwent surgery, three patients (2%) received radiotherapy only, and 22 patients (13%) received best supportive care. Regarding the operative method, 43 patients underwent pleural pneumonectomy, and six received pleurectomy/decortication. As chemotherapy, the regimen included gemcitabine in 32 cases, and pemetrexed in 64 cases. The median survival time in the chemotherapy arm was 11.0 months versus 29.0 months in those treated surgically (P<0.01, log-rank test). In the groups receiving/not receiving pemetrexed, the median survival time was in 14.0 and 9.0 months, respectively, showing a significant difference. On multivariable analysis of overall survival, a performance status ≥2, non-epithelial, clinical stage III+V, LMR <2.74, and the absence of surgery were indicators of a poor prognosis. Conclusion: The results suggest the effectiveness of surgery and pemetrexed - based chemotherapy.