演題抄録

パネルディスカッション

開催概要
開催回
第56回・2018年・横浜
 

悪性胸膜中皮腫に対する集学的治療法の確立を目的とした多施設共同臨床試験

演題番号 : PD22-3

[筆頭演者]
演者)長谷川 誠紀:1 

1:兵庫医科大学・呼吸器外科

 

Recent medical progress has led to significantly improved therapeutic outcome in patients with malignant pleural mesothelioma (MPM).
At the Hyogo College of Medicine, results of curative-intent surgery after 2009 (n=132) were strikingly improved in comparison with those before 2009 (n=26): 49.8 month vs.17.7 months in the median survival time, 35.2% vs. 23.1% in the 5-year survival rate, and 0.8% vs. 3.8% in the 30-day mortality rate. Postoperative quality of life was also improved when EPP was switched to P/D.
Thus, quality of multimodality treatment for MPM in high-volume centers has reached to an acceptable level. However, uniform accessibility to standardized treatment has not yet implemented because MPM is a rare disease.
Nationwide clinical trials have played significant roles to solve the above problem. First, clinical trials will raise attention from non-experts who are otherwise not interested in rare diseases like MPM. Second, clinical trials require standardization of technical terms, pathological diagnosis, and treatment methodologies. Third, highly reliable data could be obtained through prospective multicenter trials.
In the JMIG 0601 study, the central diagnosis was performed on the pathology, and it revealed that the diagnostic criteria deviated even by MPM experts. JMIG 1101 studyobligated to submit photographs and videos of surgical procedures to clarify employed surgical technique. As a result, this study significantly contributed for standardization of P/D technique.
A non-interventional, prospective, observational cohort study of patients with MPM is currently ongoing. Since this study requires tumor stage description using both of the 7th and 8th versions of IMIG staging system, it verifies the validity ofVer. 8 staging system. Furthermore, this study requires the maximum tumor thickness and the three-level tumor thickness (Sum of 3-level thickness) which are highly likely to be adopted in the Ver.9 IMIG staging system.

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