AI Article Synopsis
- This study examines the survival rates of pleural mesothelioma patients who either underwent surgery after neoadjuvant chemotherapy or refused surgery entirely.
- A total of 296 eligible patients were analyzed, with 272 choosing surgery and 24 refusing; the results indicated that those who had surgery experienced significantly better overall survival (40.7 months) and progression-free survival (20.2 months) compared to those who refused surgery (23.6 months and 12.9 months, respectively).
- The findings suggest that surgical intervention may significantly enhance survival outcomes for patients diagnosed with pleural mesothelioma.
Article Abstract
Background: The effects of surgery on the survival of patients with pleural mesothelioma remain poorly understood. We compared the therapeutic outcomes of patients receiving neoadjuvant chemotherapy, followed by surgery or refusing surgery, for pleural mesothelioma.
Methods: This retrospective study included consecutive patients who were eligible for curative-intent surgery after 3 cycles of neoadjuvant chemotherapy with platinum plus pemetrexed at our hospital during January 2011 to December 2021. Patients were divided into 2 groups. The surgery group comprised patients who underwent curative-intent surgery for pleural mesothelioma. The refusal-of-surgery group comprised patients who were medically eligible for surgery but refused to consent to surgery. Overall survival and progression-free survival were calculated using the Kaplan-Meier method with the generalized Wilcoxon test.
Results: Of the 296 eligible patients for the study, 272 underwent surgery and 24 refused surgery. During the surgery, 204 patients (75.0%), 43 (15.8%), and 25 (9.2%) underwent pleurectomy/decortication, extrapleural pneumonectomy, and exploratory thoracotomy, respectively. The median follow-up length was 28.4 months. The median overall survival periods were 40.7 months (95% CI, 32.2-45.6 months) for surgery and 23.6 months (95% CI, 15.2-43.0 months) for refusal of surgery (P = .03). The median progression-free survival periods were 20.2 months (95% CI, 17.0-22.5 months) for surgery and 12.9 months (95% CI, 8.3-16.8 months) for refusal of surgery (P < .001).
Conclusions: Overall survival and progression-free survival were significantly better in surgery than in refusal of surgery. Surgery may improve the survival outcomes of patients with pleural mesothelioma.
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| http://dx.doi.org/10.1016/j.athoracsur.2024.02.022 | DOI Listing |
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