Abstract
Introduction: Malignant Pleural Mesothelioma (MPM) is characterized by an aggressive behavior and an inevitably fatal prognosis, whose treatment is still far from being standardized. The role of surgery is questionable since a radical resection is unattainable in most cases. Hyperthermic IntraTHOracic Chemotherapy (HITHOC) combines the advantages of antitumoral effects together with those of high temperature on the exposed tissues with the aim to improve surgical radicality. Material and Methods: this is a narrative review on the role of HITHOC in the management of MPM patients. To provide data on the beginnings and the historical evolution of this technique, we searched the available literature by selecting the more exhaustive papers on this topic. Results: from 1994 to date different authors experimented HITHOC following a cytoreductive surgery in MPM, obtaining in most cases a good local control and a better overall survival associated to very low complication rate. Conclusions: HITHOC may be considered as a safe, feasible and effective procedure although there is a high heterogeneity between different protocols adopted worldwide. More structured studies are needed to reach a unanimous consensus on this technique.
Highlights
IntroductionMalignant Pleural Mesothelioma (MPM) is a rare neoplasia arising from mesothelial cells lining serous cavities, characterized by an aggressive behavior and an inevitably fatal prognosis
Malignant Pleural Mesothelioma (MPM) is characterized by an aggressive behavior and an inevitably fatal prognosis, whose treatment is still far from being standardized
Malignant Pleural Mesothelioma (MPM) is a rare neoplasia arising from mesothelial cells lining serous cavities, characterized by an aggressive behavior and an inevitably fatal prognosis
Summary
Malignant Pleural Mesothelioma (MPM) is a rare neoplasia arising from mesothelial cells lining serous cavities, characterized by an aggressive behavior and an inevitably fatal prognosis. Due to MPM features and the typically advanced age of patients at the diagnosis, treatment options are extremely limited; where surgical role remains controversial and reserved to selected patients after a multidisciplinary tumor board assessment; while most patients were addressed to chemotherapy with platinum plus pemetrexed in first line as standard of care or to radiation-therapy, this latter mainly with palliative intent or in a adjuvant setting [5]. Because of the scarce success of any single modality of treatment in affecting long-term outcomes, the prognosis of MPM affected patients remains extremely poor many hopes hang on other novel strategies based mainly on immunotherapy [6]. Intrathoracic Chemotherapy (HITHOC) to improve loco-regional effect of surgery despite lower impact in terms of systemic toxicity [13]
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