Oncological Outcomes Of Radical Surgery With And Without Induction And Adjuvant Chemotherapy In Mesothelioma Patients...

Area of Science:

• Oncology
• Surgical Oncology
• Thoracic Surgery

Background:

• Mesothelioma is a rare cancer with a long latency period, often diagnosed decades after asbestos exposure.
• Optimal treatment strategies for mesothelioma remain a subject of ongoing clinical debate.
• The disease's insidious nature necessitates effective therapeutic interventions to improve patient survival.

Purpose of the Study:

• To evaluate the oncological outcomes of different treatment modalities for mesothelioma.
• To compare disease-free survival (DFS) and 1-year survival rates across various therapeutic approaches.
• To determine the most advantageous treatment sequence for improving patient prognosis.

Main Methods:

• Retrospective analysis of 16 mesothelioma cases treated between January 2016 and December 2020.
• Evaluation of disease-free survival and 1-year survival based on treatment schemes: neoadjuvant chemotherapy with surgery, surgery alone, upfront surgery with adjuvant chemotherapy, and multimodal therapy (neoadjuvant and adjuvant chemotherapy with surgery).

Main Results:

• Multimodal therapy (neoadjuvant and adjuvant chemotherapy with surgery) showed the longest median follow-up period (MFUP), DFS, and 1-year survival (83%).
• Patients treated with radical surgery alone had the poorest outcomes, with a 33% 1-year survival rate and 6-month DFS.
• Upfront surgery with adjuvant chemotherapy yielded a 67% 1-year survival rate and 15-month DFS.

Conclusions:

• A multimodal approach incorporating neoadjuvant and adjuvant chemotherapy alongside surgical resection significantly improves DFS and 1-year survival in mesothelioma patients.
• Radical surgery as a standalone treatment is associated with inferior oncological outcomes.
• The timing of systemic therapy (neoadjuvant vs. adjuvant) did not appear to impact recurrence rates.