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The Management Of Malignant Pleural Mesothelioma.

G. Maggi, C. Casadio, R. Giobbe, E. Ruffini
Published 2003 · Medicine

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there was a local recurrence of the tumor 2 years after the last operation on the thorax (right upper lobe of the lung, right pulmonary hilum, and behind the sternum). Surgical resection was not indicated because a right pneumonectomy under permanent left phrenic paralysis would have been necessary for a complete resection. Concurrent chemoradiotherapy using cisplatin (10 mg) 1 5-FU (50 mg) twice a week for 1 month (irradiation 66 Gy totally) was effective and the patient is doing well 1.5 years after treatment and 16 years after the primary operation. I would like to emphasize the importance of long-term follow up of the patient with this tumor. In our case, the first local recurrence was seen 5 years after the primary operation followed by prophylactic adjuvant chemotherapy. In recent reports, Tsuchida et al. [2] described one long-term survivor of this tumor who had a recurrence 6 years after the primary operation and another who had a recurrence 8 years after the primary operation. It would be suggested that this tumor is malignant but slow-moving. Body CT scanning is required for long-term postoperative follow-up to find small tumor recurrences and it would be concluded in the early surgical intervention. In conclusion, because this is a rare tumor, it is very difficult to collect evidence for appropriate treatment in a prospective study. As thoracic oncologists, it is our responsibility to report our experiences with these cases on a global scale.
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