EXTRAPLEURAL PNEUMONECTOMY WITH HYPERTHERMIC INTRAPLEURAL CHEMOTHERAPY IN THE TREATMENT OF PLEURAL MESOTHELIOMA: A CLINICAL CASE

A.A. Aksarin1,2, S.M. Kopeyka1

1Surgut District Clinical Hospital, Surgut

2Surgut State University, Surgut

Aksarin Aleksey A. ― Doct. of Sci. (Med.), Head of the district cancer center Surgut District Clinical Hospital; Associate Professor of the Department of Surgical Diseases of the Surgut State University

24 Energetikov Str., building 2, Surgut, 628408, Russian Federation, tel.: +7-922-650-89-40, (3462) 52-71-07, e-mail: alexaa1971@mail.ru; SPIN-code: 3942-3223, AuthorID (SCOPUS): 256495, ORCID ID: 0000-0002-7441-9846, Researcher ID (WOS): JRY-4487-2023

Abstract. Malignant pleural mesothelioma (MPM) is a rare malignant neoplasm. In 2020, 30 000 patients worldwide were diagnosed with mesothelioma. Tumor biology is aggressive and prognosis is poor. Despite more knowledge on histology, tumor biology and staging, there is still a relevant discrepancy between clinical and pathologic staging Unsurprisingly, there is still no consensus on the optimal treatment strategy. Surgical treatment has been and remains a subject of debate. In principle, surgery is an effective approach because it allows the complete removal of a macroscopically visible tumor that is relatively resistant to drug therapy. In addition, to date, the best long-term result is achieved with multimodal treatment. However, part of the cancer community believes that surgical intervention is associated with too high a level of complications and postoperative mortality compared with a limited life expectancy. This criticism is understandable, since poor results are reported after surgery. In this article, we will consider the indications for surgical treatment and consider various options for surgical intervention. The clinical experience of successful surgical treatment of MPM in combination with intrapleural hyperthermic chemotherapy (HITHOC) is presented.

Key words: malignant pleural mesothelioma, extrapleural pneumonectomy, pleurectomy/decortication, intrapleural hyperthermic chemotherapy, macroscopic complete resection.