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Does Surgery Has a Role on Stage III Malignant Pleural ?Mesothelioma ?
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A7314 - Does Surgery Has a Role on Stage III Malignant Pleural ?Mesothelioma ?
Author Block: J. Kelly-Garcia1, E. M. Garcia-Bazan2, D. Zamora-Lemus2, E. Lazcano-Hernandez2, H. K. Mandujano-Khoval3; 1Oncology, Onco Quality Care S de Rl de CV, Mexico City, Mexico, 2Thoracic Oncology, CMN S-XXI IMSS, Mexico City, Mexico, 3Surgical Oncology, HGZ 30 IMSS, Mexicali BC, Mexico.
The role of surgery on Epithelial Malignant Pleural Mesothelioma remains controversial as it is considered a cytoreductive procedure, in the other hand, most cytotoxic drugs and new molecular targets have no curative role and a low impact on survival. On a biological basis the tumor response to pharmacological treatment is related to cell susceptibility and tumor burden. With surgery as initial treatment the possibility of chemoresistance can be reduced and a better clinical response achieved. Historically the survival of symptomatic patients with advance locoregional EMPM is less than a year when treated on nonsurgical basis. Surgery is the only treatment that reduces tumor load on one event and considering the improvement on surgical technics and anesthesia, the morbidity and mortality of the panpleuropneumonectomy has become aceptable. We retrospectively reviewed our experience on stage II and III to report the survival on a twelve years period that ended on 2014. Seventeen cases were included, seven stage II and ten stage III. No mortality was observed and the main morbidity was cardiac arrhytmia on 30.4 %. All patients received adjuvant chemo based on platinum. The average survival was 24.3 months, with 24.8 for stage II and 23.5 for stage III, without statistical significancy . We concluded that stage II and III of MPM must be initially treated with panpleuropneumonectomy as part of their multimodal treatment every time that a complete macroscopic removal seems feasible.
Author Block: J. Kelly-Garcia1, E. M. Garcia-Bazan2, D. Zamora-Lemus2, E. Lazcano-Hernandez2, H. K. Mandujano-Khoval3; 1Oncology, Onco Quality Care S de Rl de CV, Mexico City, Mexico, 2Thoracic Oncology, CMN S-XXI IMSS, Mexico City, Mexico, 3Surgical Oncology, HGZ 30 IMSS, Mexicali BC, Mexico.
The role of surgery on Epithelial Malignant Pleural Mesothelioma remains controversial as it is considered a cytoreductive procedure, in the other hand, most cytotoxic drugs and new molecular targets have no curative role and a low impact on survival. On a biological basis the tumor response to pharmacological treatment is related to cell susceptibility and tumor burden. With surgery as initial treatment the possibility of chemoresistance can be reduced and a better clinical response achieved. Historically the survival of symptomatic patients with advance locoregional EMPM is less than a year when treated on nonsurgical basis. Surgery is the only treatment that reduces tumor load on one event and considering the improvement on surgical technics and anesthesia, the morbidity and mortality of the panpleuropneumonectomy has become aceptable. We retrospectively reviewed our experience on stage II and III to report the survival on a twelve years period that ended on 2014. Seventeen cases were included, seven stage II and ten stage III. No mortality was observed and the main morbidity was cardiac arrhytmia on 30.4 %. All patients received adjuvant chemo based on platinum. The average survival was 24.3 months, with 24.8 for stage II and 23.5 for stage III, without statistical significancy . We concluded that stage II and III of MPM must be initially treated with panpleuropneumonectomy as part of their multimodal treatment every time that a complete macroscopic removal seems feasible.
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