DOI 10.1378/chest.113.1_Supplement.61S
1998;113;61S-65S
Chest
David J. Sugarbaker and Jose J. Norberto
Pleural Mesothelioma
Multimodality Management of Malignant
61S
http://chestjournal.chestpubs.org/content/113/1_Supplement/
and services can be found online on the World Wide Web at:
The online version of this article, along with updated information
ISSN:0012-3692
)
http://chestjournal.chestpubs.org/site/misc/reprints.xhtml
(
of the copyright holder.
may be reproduced or distributed without the prior written permission
Northbrook, IL 60062. All rights reserved. No part of this article or PDF
by the American College of Chest Physicians, 3300 Dundee Road,
1998
Physicians. It has been published monthly since 1935. Copyright
CHEST is the official journal of the American College of Chest
1998 by the American College of Chest Physicians
by guest on March 2, 2010
chestjournal.chestpubs.org
Downloaded from
Multimodality Management of
Malignant Pleural
Mesothelioma*
David J. Sugarbaker, MD, FCCP; and Jose J. Norberto, MD
In this article, we explain the current trimodality
approach used to treat malignant pleural mesotheli¬
oma. Our current approach employs extrapleural
pneumonectomy as the cytoreductive procedure fol¬
lowed by combination chemoradiotherapy. Trimo¬
dality therapy was performed at the Dana-Farber
Cancer Institute/Brigham and Women's Hospital
Thoracic Oncology Program. From 1980 to 1995, we
prospectively followed up a series of 120 patients
with confirmed malignant pleural mesothelioma who
underwent trimodality therapy. Two- and 5-year
survival rates for the entire cohort were 45% and
22%, respectively. Survival rates were 65% and 27%,
respectively, at 2 and 5 years for patients with
epithelial histology. Patients with sarcomatous or
mixed histology had the poorest prognosis, with 2-
and 5-year survival rates of 20% and 0%, respec¬
tively. For patients with epithelial tumors and nega¬
tive nodes, survival at 2 and 5 years was 74% and
39%, respectively. Extrapleural pneumonectomy in
the cont