{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:22:09Z","timestamp":1787962929914,"version":"build-2784847793"},"reference-count":30,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T00:00:00Z","timestamp":1713571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"German Research Association","doi-asserted-by":"publisher","award":["RI2905\/3-1"],"award-info":[{"award-number":["RI2905\/3-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Cytoreductive surgery (CRS) combined with hyperthermic intrathoracic chemoperfusion (HITOC) is a promising treatment strategy for pleural mesothelioma (PM). The aim of this study was to evaluate the impacts of this multimodal approach in combination with systemic treatment on disease-free survival (DFS) and overall survival (OS). In this retrospective multicenter study, clinical data from patients after CRS and HITOC for PM at four high-volume thoracic surgery departments in Germany were analyzed. A total of 260 patients with MPM (220 epithelioid, 40 non-epithelioid) underwent CRS and HITOC as part of a multimodal treatment approach. HITOC was administered with cisplatin alone (58.5%) or cisplatin and doxorubicin (41.5%). In addition, 52.1% of patients received neoadjuvant and\/or adjuvant chemotherapy. The median follow-up was 48 months (IQR = 38 to 58 months). In-hospital mortality was 3.5%. Both the resection status (macroscopic complete vs. incomplete resection) and histologic subtype (epithelioid vs. non-epithelioid) had significant impacts on DFS and OS. In addition, adjuvant chemotherapy (neoadjuvant\/adjuvant) significantly increased DFS (p = 0.003). CRS and HITOC within a multimodal treatment approach had positive impacts on the survival of patients with epithelioid PM after macroscopic complete resection. The addition of chemotherapy significantly prolonged the time to tumor recurrence or progression.<\/jats:p>","DOI":"10.3390\/cancers16081587","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T03:57:07Z","timestamp":1713758227000},"page":"1587","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Multimodal Treatment of Pleural Mesothelioma with Cytoreductive Surgery and Hyperthermic Intrathoracic Chemotherapy: Impact of Additive Chemotherapy"],"prefix":"10.3390","volume":"16","author":[{"given":"Laura V.","family":"Klotz","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University Hospital Heidelberg, 69126 Heidelberg, Germany"},{"name":"German Center for Lung Research (DZL), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9806-3397","authenticated-orcid":false,"given":"Julia","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Ludwig-Maximilians-University Munich, Asklepios Lung Clinic Gauting, 82131 Gauting, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5241-2945","authenticated-orcid":false,"given":"Karolina","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1952-399X","authenticated-orcid":false,"given":"Julia","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Ludwig-Maximilians-University Munich, Asklepios Lung Clinic Gauting, 82131 Gauting, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5973-264X","authenticated-orcid":false,"given":"Mohamed","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Koller","sequence":"additional","affiliation":[{"name":"Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severin","family":"Schmid","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Huppertz","sequence":"additional","affiliation":[{"name":"Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"Markowiak","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernward","family":"Passlick","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Freiburg, 79106 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Stefan","family":"Hofmann","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"},{"name":"Department of Thoracic Surgery, Barmherzige Br\u00fcder Hospital Regensburg, 93049 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hauke","family":"Winter","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University Hospital Heidelberg, 69126 Heidelberg, Germany"},{"name":"German Center for Lung Research (DZL), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf A.","family":"Hatz","sequence":"additional","affiliation":[{"name":"German Center for Lung Research (DZL), 69120 Heidelberg, Germany"},{"name":"Division of Thoracic Surgery, Ludwig-Maximilians-University Munich, Asklepios Lung Clinic Gauting, 82131 Gauting, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin E.","family":"Eichhorn","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Thoraxklinik, University Hospital Heidelberg, 69126 Heidelberg, Germany"},{"name":"German Center for Lung Research (DZL), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2365-4803","authenticated-orcid":false,"given":"Michael","family":"Ried","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tedesco, J., Jaradeh, M., and Vigneswaran, W.T. 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