Retrospective study of local treatment for oligo-recurrence of diffuse pleural mesothelioma after extended pleurectomy/decortication

A retrospective study at the Institute of Science Tokyo Hospital (Japan) evaluated recurrence patterns and assessed efficacy of local treatment for oligo-recurrence in patients with diffuse pleural mesothelioma (PM) following extended pleurectomy/decortication (P/D) with multimodal therapy. The study included 69 patients undergoing extended P/D and intraoperative hyperthermic cisplatin between October 2010 and September 2025. Macroscopic complete resection was achieved in all patients, and there was one in-hospital mortality (1.4%). Sixty-one patients (88.4%) received multimodal therapu. Recurrence occurrend in 52 patients (75%). The median recurrence-free survival was 15.0 months. The type of recurrence was local in 32 patients (62%), distant in six (12%), and both in 14 (27%). Local treatment was administered to 16 patients with oligo-recurrence (second surgery in 14; radiation therapy in two). Twenty-seven patients underwent repeated local treatments (surgery in 20, radiation therapy in seven). The median post-recurrence survival (PRS) of 52 patients was 13.9 months. The PRS was systemic chemotherapy was 11.4 months, while the PRS with addition of oligo-recurrence treatment was 45.6 months. The authors conclude that local treatment for oligo-recurrence after extended P/D showed favorable survival outcomes.