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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Post-Recurrence Treatment Patterns and Outcomes After Curative-Intent Multimodality Strategy in Patients with Pleural Mesothelioma: A Retrospective Cohort Study

  • Oliver Illini1,2
  • Hannah Fabikan2
  • Irene Berghammer3
  • Julie Krainer-Jacobs2
  • Amelie Schneeweiss-Worel4
  • Leyla Ay1,2
  • Daniel Moser1,2
  • Christoph Weinlinger2
  • Anna Lang-Stöberl2
  • Maximilian J. Hochmair1,2
  • Michal Benej4,5
  • Tibor Krajc4,5
3 more authors
  • Thomas Klikovits4,5
  • Arschang Valipour1,2
  • Stefan Watzka4,5,6
6 affiliations
  1. 1Department of Respiratory and Critical Care Medicine, Klinik Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria
  2. 2Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, 1210 Vienna, Austria
  3. 3Department of Respiratory and Pulmonary Diseases, Klinik Hietzing, Vienna Healthcare Group, 1130 Vienna, Austria
  4. 4Department of Thoracic Surgery, Klinik Floridsdorf, Vienna Healthcare Group, 1210 Vienna, Austria
  5. 5Karl Landsteiner Institute for Thoracic Surgical Research, Klinik Floridsdorf, 1210 Vienna, Austria
  6. 6Paracelsus Medical University, 5020 Salzburg, Austria
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Abstract

Background: Disease recurrence is common after surgery for pleural mesothelioma (PM), and the evidence guiding post-recurrence management remains limited. Methods: We conducted a retrospective, single-center cohort study including patients with PM treated within a curative-intent multimodality treatment pathway including surgery aiming for a macroscopic complete resection when feasible between 2001 and 2024. Post-recurrence treatments were categorized as best supportive care only (BSC), systemic therapy alone, or local with or without systemic therapy. Survival and disease-free outcomes were analyzed in relation to treatment patterns and clinical prognostic factors. Results: Among 67 patients with a median follow-up time of 107 months from surgery, 58 (86.6%) developed disease recurrence. At first recurrence, 21 patients (36%) received local with or without systemic therapy, 26 (45%) systemic therapy alone, and 11 (19%) BSC. The median post-recurrence survival was 21.7 months for patients receiving local with or without systemic therapy, 10.8 months for systemic therapy alone, and 1.6 months for BSC. Lung-sparing surgery and a disease-free interval of at least 12 months were associated with improved post-recurrence survival and post-recurrence progression-free survival. Conclusions: In this real-world cohort of patients with PM and extended follow-up, active post-recurrence treatment was associated with longer post-recurrence survival in selected patients. However, conclusions regarding their comparative effectiveness are limited by the retrospective design, incomplete recurrence-related data, and patient selection at recurrence.

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Cite

BibTeXRIS
BibTeX
@article{illini2026postrecurrence,
  title = {{Post-Recurrence Treatment Patterns and Outcomes After Curative-Intent Multimodality Strategy in Patients with Pleural Mesothelioma: A Retrospective Cohort Study}},
  author = {Oliver Illini and Hannah Fabikan and Irene Berghammer and Julie Krainer-Jacobs and Amelie Schneeweiss-Worel and Leyla Ay and Daniel Moser and Christoph Weinlinger and Anna Lang-Stöberl and Maximilian J. Hochmair and Michal Benej and Tibor Krajc and Thomas Klikovits and Arschang Valipour and Stefan Watzka},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15208137},
  url = {https://www.mdpi.com/2077-0383/15/20/8137},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Post-Recurrence Treatment Patterns and Outcomes After Curative-Intent Multimodality Strategy in Patients with Pleural Mesothelioma: A Retrospective Cohort Study
AU  - Oliver Illini
AU  - Hannah Fabikan
AU  - Irene Berghammer
AU  - Julie Krainer-Jacobs
AU  - Amelie Schneeweiss-Worel
AU  - Leyla Ay
AU  - Daniel Moser
AU  - Christoph Weinlinger
AU  - Anna Lang-Stöberl
AU  - Maximilian J. Hochmair
AU  - Michal Benej
AU  - Tibor Krajc
AU  - Thomas Klikovits
AU  - Arschang Valipour
AU  - Stefan Watzka
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15208137
UR  - https://www.mdpi.com/2077-0383/15/20/8137
AB  - Background: Disease recurrence is common after surgery for pleural mesothelioma (PM), and the evidence guiding post-recurrence management remains limited. Methods: We conducted a retrospective, single-center cohort study including patients with PM treated within a curative-intent multimodality treatment pathway including surgery aiming for a macroscopic complete resection when feasible between 2001 and 2024. Post-recurrence treatments were categorized as best supportive care only (BSC), systemic therapy alone, or local with or without systemic therapy. Survival and disease-free outcomes were analyzed in relation to treatment patterns and clinical prognostic factors. Results: Among 67 patients with a median follow-up time of 107 months from surgery, 58 (86.6%) developed disease recurrence. At first recurrence, 21 patients (36%) received local with or without systemic therapy, 26 (45%) systemic therapy alone, and 11 (19%) BSC. The median post-recurrence survival was 21.7 months for patients receiving local with or without systemic therapy, 10.8 months for systemic therapy alone, and 1.6 months for BSC. Lung-sparing surgery and a disease-free interval of at least 12 months were associated with improved post-recurrence survival and post-recurrence progression-free survival. Conclusions: In this real-world cohort of patients with PM and extended follow-up, active post-recurrence treatment was associated with longer post-recurrence survival in selected patients. However, conclusions regarding their comparative effectiveness are limited by the retrospective design, incomplete recurrence-related data, and patient selection at recurrence.
SN  - 2077-0383
ER  -