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Outcomes

Professor Lang-Lazdunski, from The Mesothelioma Clinic, reported his 10-year experience of a multi-modality regimen involving radical pleurectomy and hyperthermic pleural lavage with povidone-iodine, together with systemic chemotherapy, at the annual meeting of the American Association of Thoracic Surgery in Toronto in April 2014.

In more than 100 operations, no mortality occurred and there was a median overall survival of 32 months - one of the best ever reported in the field. He showed that the cell sub-type was a very important prognostic factor; patients with Epithelioid Mesothelioma lived significantly longer (median survival over 35 months) than those with biphasic or sarcomatoid sub-type (median survival 15 months) following multi-modality therapy.

After five years, more than a third of patients with Epithelioid Mesothelioma were alive. Another important finding in that study was that complete macroscopic resection was significantly associated with survival: patients in whom the surgeon could remove all visible tumours lived longer than those who had any tumour left behind. This is a very important point as mesothelioma surgery is demanding and there is a long learning curve.

Survival based on CMRSurvival curve (Kaplan-Meier Method) Showing increased survival following removal of tumourSurvival-based-on-CMRIt has been shown by others that mortality, complication rates, and survival are better centres, dealing with a large number of mesothelioma operations. Professor Lang-Lazdunski and colleagues showed the role and importance of PET-CT in the diagnosis, prognosis and follow-up of malignant pleural mesothelioma. He was the first to report the use of Cyberknife, a relatively new stereotactic radiotherapy tool, in malignant pleural mesothelioma.

Our team at The Lister Hospital in London currently has the best outcomes worldwide, with more than 1 in three patients with epithelioid mesothelioma alive beyond 5 years.