全国アンケート調査による本邦の悪性胸膜中皮腫に対する外科治療成績

摘要

Surgical results of patients with malignant pleural mesothelioma (MPM) in Japan was surveyed from the results of a questionnaire sent to members of the Japan Lung Cancer Society, and a total of 132 surgical cases of MPM from 1997 to 2002 were analyzed.They consisted of 112 males and 20 females. By histological type, 87 cases had epithelial type, 10 had sarcomatous type, 26 had mixed type and 2 had uncommon type of MPM (the histology of 7 cases was not indicated). As to the surgical mode, extrapleural pneumonectomy (EPP) was performed in 73 cases, and limited surgery such as decortication and tumorectomy was performed in 59 cases. The tumor was potentially completely resected in 83 cases. Postoperative adjuvant therapy was performed in 56 cases. The 1-, 2- and 3-year survival rates of the present cases were 54, 33 and 21% , respectively, and the perioperative mortality rate was 5%. These survival and mortality rates in the present series were almost similar to those of the MPM cases in the previously reported series from 1987 to 1996 by Takagi et al.According to Cox regression analysis, prognostic factors for survival included postoperative adjuvant therapy (p=0.003) and complete resection (p=0.037) significantly, and International Mesothelioma Interest Group (IMIG) stage (p=0.051) and performance status (p=0.086) with a marginal significance, indicating that complete surgical resection of the tumor and perioperative adjuvant therapy could be effective treatment for MPM in Japan. Thus, the development of multimodality therapy including surgical treatment for this disease may be required to improve surgical results of MPM patients.