First report of pleural mesothelioma treated with cytoreductive surgery and hyperthermic intrathoracic chemotherapy in Kazakhstan: a case report

Our plain-English summary of First report of pleural mesothelioma treated with cytoreductive surgery and hyperthermic intrathoracic chemotherapy in Kazakhstan: a case report, by K. Nurtas, D. Alexandr, Z. Bakhyt, et al (Journal of Medical Case Reports, 2026).

The study

• Authors: K. Nurtas, D. Alexandr, Z. Bakhyt, M. Nurlan, S. Sanzhar, B. Zhandos, J. Saparbay
• Journal: Journal of Medical Case Reports
• Published: 2026;20(1)
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Malignant pleural mesothelioma (MPM) is a rare but aggressive neoplasm arising from the mesothelial lining of the pleura.Despite advancements in systemic chemotherapy and targeted therapies, the prognosis for MPM remains poor, with a median survival of 8-14 months. Standard treatment modalities include surgery in combination with radiotherapy and/or chemotherapy. Hyperthermic Intrathoracic Chemotherapy (HITOC) has emerged as a promising adjunct to surgery.

Case Presentation: A 35-year-old Asian male was diagnosed with Stage II malignant pleural mesothelioma (T2N0M0). The patient underwent systemic chemotherapy consisting of six cycles of pemetrexed, carboplatin, and bevacizumab. The PET-CT demonstrated stabilization of the disease, with no evidence of metabolic activity or tumor growth, suggesting a positive response to chemotherapy. Considering the localized nature of the disease and the absence of significant progression, the patient underwent cytoreductive surgery with Hyperthermic Intrathoracic Chemotherapy (HITOC) as the next step in treatment.

Conclusion: This case reports first successful application of HITOC for patient with MPM in Kazakhstan. It underscores the practical considerations, safety profile, and outcomes, contributing to the growing body of evidence supporting this approach.

© 2026. The Author(s).

In plain English

This was a case report from the National Research Oncology Center in Astana, Kazakhstan, describing one patient with malignant pleural mesothelioma. The patient, a 35-year-old Asian male, developed dry cough, breathlessness and fatigue in late 2022, and a right-sided biopsy of the pleura confirmed the diagnosis. The disease was classed as Stage II (T2N0M0). The article does not report whether the patient had any asbestos exposure. The patient received six cycles of pemetrexed, carboplatin and bevacizumab from March to July 2023, after which imaging including PET-CT showed the disease had stabilized. The patient then had cytoreductive surgery (open thoracotomy with pleurectomy) followed by heated cisplatin chemotherapy delivered into the chest (hyperthermic intrathoracic chemotherapy, HITOC) at 42 °C for 40 minutes. The authors reported no significant complications and no evidence of lesion growth on a CT scan three months after surgery. The discussion instead refers to a one-month follow-up. The authors described this as the first successful use of HITOC for this disease in Kazakhstan and said further research and clinical trials are needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (single patient)
• Who was studied: One 35-year-old Asian male with malignant pleural mesothelioma, treated at the National Research Oncology Center, Astana, Kazakhstan. Symptoms began in late 2022. Other conditions included arterial hypertension, obesity, steatohepatitis and gallstone disease.
• Exposure: The article does not report any asbestos or other occupational or environmental exposure for this patient. The report concerns treatment, not cause.
• Main results:
  • The patient was diagnosed with Stage II (T2N0M0) malignant pleural mesothelioma after a right-sided thoracoscopic pleural biopsy with positive D2-40 staining.
  • After six cycles of pemetrexed, carboplatin and bevacizumab (March to July 2023), imaging including PET-CT showed stabilization of the disease, with no evidence of metabolic activity or tumor growth.
  • The patient underwent cytoreductive surgery (open thoracotomy with pleurectomy) followed by hyperthermic intrathoracic chemotherapy with cisplatin at 42 °C for 40 minutes.
  • The patient had no significant complications, such as cisplatin-induced kidney damage or breathing problems after surgery.
  • A CT scan three months after surgery and HITOC showed no evidence of lesion growth.
  • The discussion states there was no evidence of recurrence at the one-month follow-up.
• The authors' conclusion: The authors concluded that the case showed successful use of HITOC in a patient with malignant pleural mesothelioma and suggested a possible role for it as an add-on treatment. They stated that further research and clinical trials are needed to establish its efficacy and safety as a standard treatment.
• Limitations the authors state:
  • The authors note, as a limitation of HITOC in general rather than of this report, that there are no standardized protocols for the choice and dose of drugs, the perfusion temperature, or the duration. This makes outcomes hard to compare across centers.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Cytoreductive Surgery, Intrathoracic, Chemotherapy, Neoplasm, Pleura, Prognosis, Median Overall Survival.

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• Present and future of cytoreductive surgery and hyperthermic intrathoracic chemotherapy for pleural metastases: a narrative review — A. Hajja, M. Atout, et al. (2026)
• Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: a systematic review and meta-analysis — J.H. Helm, J.T. Miura, et al. (2015)
• The Role of Ki-67 and Pre-cytoreduction Parameters in Selecting Diffuse Malignant Peritoneal Mesothelioma (DMPM) Patients for Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) — S. Kusamura, P.A. Torres Mesa, et al. (2016)
• A Novel Tool for Predicting Major Complications After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy — J.M. Baumgartner, T.G. Kwong, et al. (2016)

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