Hyperthermic Intrathoracic Chemotherapy in Patients with Malignant Pleural Mesothelioma After Macroscopic Complete Resection Procedures: A Systematic Review

Elsayed HH, Alanany M, El Sayegh MT and Abdel-Gayed M

Department of Thoracic Surgery, Ain Shams University Hospital, Egypt
Department of Cardiothoracic Surgery, Ain Shams University Hospital, Egypt

^*Correspondance to: Hany Hasan Elsayed 

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Abstract:

A best evidence topic in thoracic oncology was written according to a structured protocol. The question addressed was in patients with malignant pleural mesothelioma who undergo macroscopic complete resection does performing a Hyperthermic Intrathoracic Chemotherapy (HITOCH) lead to improvement in survival? 305 papers were found using the reported search, 21 were relevant to our topic and only 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Five studies demonstrated a survival benefit for patients receiving HITOCH with a median survival ranging from 13 to 35 months in comparison to 11 to 22.8 months for the non HITOCH group. Three out of the five studies compared EPP to EPD as the surgical preference for MCR. One study used povidone iodine instead of intrathoracic chemotherapy. Only one study by Van Sandick et al. found a negative outcome with HITOCH in patients performing EPP (11 vs. 29 months). There was no reported mortality in relation to complications associated with HITOCH. The most common complication was atrial fibrillation followed by renal impairment. Despite the heterogeneity and co-founding with lack of randomized controlled trials, the body of evidence identified in this work has demonstrated that for patients with MPM undergoing MCR, hyperthermic intrathoracic chemotherapy HITHOC is one of the safe and effective therapies in prolonging patients’ median survival time and extending recurrence free interval with an acceptable safety profile.

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Cite the Article:

Elsayed HH, Alanany M, El Sayegh MT, Abdel-Gayed M. Hyperthermic Intrathoracic Chemotherapy in Patients with Malignant Pleural Mesothelioma After Macroscopic Complete Resection Procedures: A Systematic Review. Clin Oncol. 2024;9:2098..