{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:28:03Z","timestamp":1792524483256,"version":"4.5.0"},"reference-count":42,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T00:00:00Z","timestamp":1651276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Austrian Science Fund (FWF)","award":["F5508-N26"],"award-info":[{"award-number":["F5508-N26"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Malignant pleural mesothelioma (MPM) is a rare pleural cancer associated with asbestos exposure. According to current evidence, the combination of chemotherapy, surgery and radiotherapy improves patients\u2019 survival. However, the optimal sequence and weighting of the respective treatment modalities is unclear. In anticipation of the upcoming results of the MARS-2 trial, we sought to determine the relative impact of the respective treatment modalities on complications and overall survival in our own consecutive institutional series of 112 patients. Fifty-seven patients (51%) underwent multimodality therapy with curative intent, while 55 patients (49%) were treated with palliative intent. The median overall survival (OS) of the entire cohort was 16.9 months (95% CI: 13.4\u201320.4) after diagnosis; 5-year survival was 29% for patients who underwent lung-preserving surgery. In univariate analysis, surgical treatment (p &lt; 0.001), multimodality therapy (p &lt; 0.001), epithelioid subtype (p &lt; 0.001), early tumor stage (p = 0.02) and the absence of arterial hypertension (p = 0.034) were found to be prognostic factors for OS. In multivariate analysis, epithelioid subtype was associated with a survival benefit, whereas the occurrence of complications was associated with worse OS. Multimodality therapy including surgery significantly prolonged the OS of MPM patients compared with multimodal therapy without surgery.<\/jats:p>","DOI":"10.3390\/cancers14092245","type":"journal-article","created":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T05:44:07Z","timestamp":1651297447000},"page":"2245","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Multimodal Treatment of Malignant Pleural Mesothelioma: Real-World Experience with 112 Patients"],"prefix":"10.3390","volume":"14","author":[{"given":"Arnulf","family":"Holzknecht","sequence":"first","affiliation":[{"name":"Karl Landsteiner Institute for Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Division of Thoracic Surgery, Karl Landsteiner Institute of Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7322-7092","authenticated-orcid":false,"given":"Oliver","family":"Illini","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8673-2450","authenticated-orcid":false,"given":"Maximilian J.","family":"Hochmair","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"Krenbek","sequence":"additional","affiliation":[{"name":"Institute for Pathology, Klinik Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Setinek","sequence":"additional","affiliation":[{"name":"Institute for Pathology and Microbiology, Klinik Ottakring, 1160 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Huemer","sequence":"additional","affiliation":[{"name":"Division of Pulmonology, Klinik Penzing, 1140 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin","family":"Bitterlich","sequence":"additional","affiliation":[{"name":"Division of Pulmonology, Salzkammergutklinikum Voecklabruck, 4840 Voecklabruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Kaindl","sequence":"additional","affiliation":[{"name":"Division of Surgery, Salzkammergutklinikum Voecklabruck, 4840 Voecklabruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladyslav","family":"Getman","sequence":"additional","affiliation":[{"name":"Karl Landsteiner Institute for Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Division of Thoracic Surgery, Karl Landsteiner Institute of Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Akan","sequence":"additional","affiliation":[{"name":"Karl Landsteiner Institute for Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Division of Thoracic Surgery, Karl Landsteiner Institute of Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8507-2219","authenticated-orcid":false,"given":"Michael","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7837-784X","authenticated-orcid":false,"given":"Gunther","family":"Leobacher","sequence":"additional","affiliation":[{"name":"Institute of Mathematics and Scientific Computing, University of Graz, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arschang","family":"Valipour","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Karl Landsteiner Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Mueller","sequence":"additional","affiliation":[{"name":"Karl Landsteiner Institute for Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Division of Thoracic Surgery, Karl Landsteiner Institute of Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Division of Thoracic Surgery, Sigmund Freud University, 1020 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4149-4890","authenticated-orcid":false,"given":"Stefan B.","family":"Watzka","sequence":"additional","affiliation":[{"name":"Karl Landsteiner Institute for Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Division of Thoracic Surgery, Karl Landsteiner Institute of Thoracic Oncology, Klinik Floridsdorf, 1210 Vienna, Austria"},{"name":"Division of Surgery, Paracelsus Medical University, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,30]]},"reference":[{"key":"ref_1","first-page":"479","article-title":"Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma","volume":"35","author":"Scherpereel","year":"2010","journal-title":"Eur. 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