A glimpse into the role of debulking surgery and hyperthermic intrathoracic chemotherapy (HITHOC) in the management of malignant pleural mesothelioma

Abstract

Contributions: (I) Conception and design: M Migliore; (II) Administrative support: None; (III) Provision of study materials or patients: M Migliore; (IV)

Comparison of video-assisted pleurectomy/decortication surgery plus hyperthermic intrathoracic chemotherapy with VATS talc pleurodesis for the treatment of malignant pleural mesothelioma: A pilot study

“…Thoracic surgeons are aware that in mesothelioma even the most aggressive surgery treatment cannot guarantee removal of all residual cancer cells. The main objective of the HITHOC treatment has therefore been to completely eradicate any remaining cancer cells [ [10] , [11] , [12] ]. A large study on video-assisted P/D plus HITHOC was carried out at Brigham and Women's Hospital, Harvard Medical School, Boston, in 2013 [ 29 ].…”

“…Furthermore, the mean survival for patients treated with TP alone is 14 months, and P/D, which shows a mortality of 1.8%, has a reported survival of 17 months [ 6 , 7 ]. Hyperthermic Intraoperative Thoracic Chemotherapy (HITHOC) is a type of adjuvant local treatment performed in the operating room immediately after surgery for MPM [ 9 , 10 ], and many experiences and studies have been reported to date a median survival rate ranging from 20 to 35 months [ [11] , [12] , [13] ]. Nonetheless, there is no gold standard treatment for MPM, and therefore the challenge for the future is to develop strategies that will bring good quality of life, longer disease-free interval and prolonged overall survival.…”