Table 4.
Treatment | Locoregional Recurrence |
Survival | Complications |
---|---|---|---|
Supportive Care | n/a | Median OS 9–12 mo | n/a |
Extrapleural Pneumonectomy | 33–42% (site of first recurrence) | Median OS 12–32 mo | 5–10% perioperative mortality |
Pleurectomy/Decortication | 53–65% (site of first recurrence) | Median OS 12–26 mo | 3–6% perioperative mortality |
Heated Intraoperative Chemotherapy | 17–54% (site of first recurrence) | Median OS 12–26 mo | Increased rates of diaphragmatic patch failure, DVT, ARDS, and atrial fibrillation |
Systemic Chemotherapy | Median PFS 5.7–10 mo | Median OS 12.1–29.1 mo (if extrapleural penumonectomy + radiotherapy completed) | 27.2% grade III or higher complications |
Heated Povidone-Iodine | Median PFS 12 mo (89.5% local-first recurrence) | Median OS 32 mo (with pneumonectomy/decortication, radiation therapy, and adjuvant chemo) | Persistent air leak, chylothorax, pneumonia, empyema, ARDS |
Intensity Modulated Radiation Therapy | 12% at 1 year | 1-year OS 55% | 6% fatal pulmonary toxicity |
Photodynamic Therapy | Median PFS 9.6 mo | Median OS 15–31.7 mo (with surgery) | Skin burning, pain, cellulitis |
OS, overall survival; PFS progression free survival; DVT, deep venous thrombosis; ARDS, acute respiratory distress syndrome