Improved survival in patients with malignant pleural mesothelioma since 2003

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19022 Background: In our chest hospital patients with malignant pleural mesothelioma (MPM) were treated since decades. We compare patients survival before and after the introduction of a new chemotherapy regimen (platinum/pemetrexed) 2003. Methods: Between 1990 and December 2007 we diagnosed and treated 338 patients with MPM, 278 males and 60 females. All patients were retrospectively analyzed. Standard treatment in our institution for patients with good performance status is palliative surgery with pleurectomy and decortication, followed by chemotherapy. Only few patients had extra pleural pleuropneumonectomy (EPP), followed by chemotherapy. Our therapeutic strategy has not changed in the last years. We divided our patients in 2 treatment groups: those with diagnosis before 2003 (group I: 250 patients) or a diagnosis of MPM since 2003 (group II: 88 patients). Since 2003 all patients were treated with the platinum/pemetrexed combination. Results: Median survival (Kaplan-Meier-method) of all patients, diagnosed between 1990 and 2007 was 462 days with a 1- year-survival of 60% and a 2-year-survial of 37%. Median survival of group I (250 patients, 16% censored) was 352 days, compared to 652 days in group II (72% censored) and has nearly doubled. 1-year surval increased from 58% (group I) to 90% (group II), as well as the 2-year- survival, which increased from 28% (group I) to 48% (group II). Median survival of the patients with combined surgery and chemotherapy group I (104 pat., 25% censored) increased from 522 days to 1,046 days in group II (46 pat., 82% censored). In the patient group treated only with chemotherapy, 1-year survival improved from 60% to 85% and the 2-year survival from 20% to 40%. Conclusions: The introduction of an effective chemotherapy regimen 2003 with platinum/pemetrexed prolonged survival in patients with malignant pleural mesothelioma. This survival benefit was seen in multimodal treatment regiments as well in patients under chemotherapy alone. No significant financial relationships to disclose.