title: Cytoreductive surgery and post-operative heated pleural chemotherapy for the management of pleural surface malignancy.
abstract: OBJECTIVE
  We retrospectively analysed the long-term outcomes of cytoreductive surgery and post-operative heated pleural chemotherapy (HPC) for thoracic malignancies with pleural spread.
  
  
  METHODS
  Between 1987 and 2010, 160 patients were enrolled. There were 101 patients with non-small cell lung cancer (NSCLC), 25 with malignant pleural mesothelioma (MPM), 12 with thymoma, and 22 with tumours metastatic to the lung and pleura. Immediately after intra-thoracic administration of cisplatin or carboplatin, hyperthermia was performed by using an 8.00 MHz radiofrequency capacitive heating device for 1 to 4 courses in each patient.
  
  
  RESULTS
  There was no systemic toxicity or treatment-related mortality. Five-year overall survival rates were 37.4% in NSCLC, 15.9% in MPM, 91.7% in thymoma, and 25.8% in metastatic lung tumour. Five-year local relapse-free survival (RFS) rates were 55.2% in NSCLC, 24.4% in MPM, 64.8% in thymoma, and 27.2% in tumours metastatic to the lung and pleura. When 101 NSCLCs were categorised into pleural lavage cytology positive (grade 1: n = 37), limited extent of carcinomatous pleuritis (grade 2: n = 21), and extensive carcinomatous pleuritis (grade 3: n = 43), 5-year overall survival rates were 62.5%, 49.2%, and 13.6%, respectively. The local RFS was significantly better in group 1/2 than in group 3.
  
  
  CONCLUSIONS
  Although our study has some of the usual weaknesses of a single institution retrospective study, cytoreductive surgery and HPC are feasible and safe. It is suggested that HPC may have a potential role for local control as adjuvant treatment for cytoreductive surgery in patients with minor pleural spread.
authors.affiliation: Department of Thoracic Surgery, Yao Municipal Hospital , Yao City , Osaka .
authors.forename: Ken
authors.initials: K
authors.lastname: Kodama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Higashiyama
authors.forename: Jiro
authors.initials: J
authors.lastname: Okami
authors.forename: Toshiteru
authors.initials: T
authors.lastname: Tokunaga
authors.forename: Ayako
authors.initials: A
authors.lastname: Fujiwara
authors.forename: Fumio
authors.initials: F
authors.lastname: Imamura
authors.forename: Tomio
authors.initials: T
authors.lastname: Nakayama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008654:Mesothelioma / Q000473:pathology; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000473:pathology; D010997:Pleural Neoplasms / Q000556:secondary / Q000628:therapy*; D013945:Thymoma / Q000473:pathology; D013953:Thymus Neoplasms / Q000473:pathology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents