JTCVS Open

Our medical research library holds 7 studies published in JTCVS Open (2023–2026). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 5 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: Elsevier Ltd
• Published: 2020 to the present, Netherlands
• Language: English
• ISSN: 2666-2736 (electronic)
• Its record in the NLM Catalog

2020s

• Real-world outcomes of multimodal treatment for pleural mesothelioma: A retrospective study in a high-volume integrated regional center. A.S. Baskin, K. Levine, Y.Y. Hung, et al. 2026;30:101603. PubMed · Publisher · Free full text

  Abstract

  Objective: To evaluate overall survival (OS) associated with multimodal treatment regimens, including pleurectomy/decortication (PD) and systemic therapy, in patients with clinical stage I-II epithelioid pleural mesothelioma (PM).

  Methods: We identified patients with PM treated within an integrated health care system (2009-2023). We grouped patients by treatment: no treatment, surgery, systemic therapy, and multimodal treatment (surgery + systemic therapy). The primary outcome was median OS. Using multivariable Cox regression, we assessed associations between treatment and OS, adjusting for clinical characteristics. Subgroup analyses were performed for patients with clinical stage I-II epithelioid PM.

  Results: Among all eligible patients (n = 432), those who received no treatment (n = 198), surgery (n = 25), systemic therapy (n = 164), and multimodal treatment (n = 45) had median OS of 5 months (95% CI, 4-7), 11 (6-17), 13 (12-17), and 27 (20 to nonestimable [NE]) (P < .0001). Among patients with clinical stage I-II epithelioid PM (n = 112), those who received no treatment (n = 40), surgery (n = 10), systemic therapy (n = 42), and multimodal treatment (n = 20) had median OS of 10 (7-17), 29 (5-NE), 18 (17-26), and 37 (25-NE) months (P < .0005). Adjusted analyses showed improved OS relative to no treatment with multimodal treatment but not systemic therapy in the clinical stage I-II epithelioid subgroup (multimodal therapy: adjusted hazard ratio, 0.35; 95% CI, 0.15-0.85, P = .02; systemic therapy: adjusted hazard ratio, 0.66; 95% CI, 0.37-1.16, P = .15).

  Conclusions: In a real-word cohort of patients with early-stage epithelioid PM, multimodal treatment incorporating surgery and systemic therapy was associated with improved OS compared with no treatment. These findings reinforce the benefit of surgery in carefully selected patients, despite recent studies questioning its role in a broader population.

  © 2026 The Author(s).

• Commentator Discussion: Potential advantage of magnetic resonance imaging in detecting thoracic wall infiltration in pleural mesothelioma. A retrospective single-center analysis. 2025;23:326-327. PubMed · Publisher · Free full text

• Potential advantage of magnetic resonance imaging in detecting thoracic wall infiltration in pleural mesothelioma: A retrospective single-center analysis. I. Barreto, S. Franckenberg, T. Frauenfelder, et al. 2025;23:318-325. PubMed · Publisher · Free full text

  Abstract

  Objectives: Thoracic wall infiltration in pleural mesothelioma determines the extent of resection and can be an important prognostic factor. Currently, standardized imaging for restaging after neoadjuvant systemic therapy comprises contrast-enhanced computed tomography or positron emission tomography. Additional thoracic magnetic resonance imaging could better discriminate chest wall infiltration preoperatively and increase staging accuracy. For this reason, the added benefit of magnetic resonance imaging was evaluated at our center.

  Methods: A retrospective analysis of the extended imaging protocol was performed from July 2018 to March 2024, including a descriptive analysis for the patient's sex, age, tobacco consumption, asbestos exposure, histological subtype, TNM stage, Modified Response Evaluation Criteria for Solid Tumors in solid tumors, and number of neoadjuvant therapy cycles. Preoperative restaging included routine imaging and magnetic resonance imaging. After histological diagnosis of pleural mesothelioma, neoadjuvant therapy was conducted, followed by intended macroscopic complete resection, with intraoperative biopsies of suspicious chest wall lesions. Computed tomography and magnetic resonance imaging results were compared with intraoperative biopsies.

  Results: Twenty-six patients (mean age, 65.50 years, 11.50% female) with operable pleural mesothelioma were included. Of the 11 patients with histologically proven chest wall infiltration, 10 (90.91%) had a cT-stage 3 or greater and 4 (36.36%) underwent surgery that resulted in an R2 resection. Thoracic magnetic resonance imaging showed a high sensitivity (90.91%) for the detection of chest wall infiltration, especially when compared with the computed tomography scan (9.09%).

  Conclusions: With the adjunctive use of magnetic resonance imaging, we demonstrated a higher sensitivity for detection of chest wall infiltration compared with conventional imaging before surgery. This may improve patient selection for surgery. Nevertheless, larger studies are required to confirm these results.

  © 2024 The Author(s).

• Discussion to: Use of a novel microbiome modulator improves anticancer immunity in a murine model of malignant pleural mesothelioma. 2024;18:345-346. PubMed · Publisher · Free full text

• Intracavitary cisplatin-fibrin followed by irradiation improved tumor control compared to the single treatments in a mesothelioma rat model. M.B. Kirschner, M. Meerang, V. Orlowski, et al. 2024;22:491-503. PubMed · Publisher · Free full text

  Abstract

  Objective: To test the safety and efficacy of combination treatment for pleural mesothelioma (PM) with intracavitary cisplatin-fibrin (cis-fib) plus hemithoracic irradiation (IR) applied after lung-sparing surgery in an orthotopic immunocompetent rat model.

  Methods: We randomized male F344 rats into 5 groups: cis-fib (n = 9), 10 Gy IR (n = 6), 20 Gy IR (n = 9), cis-fib+10 Gy IR (n = 6), and cis-fib+20 Gy IR (n = 9). Subpleural tumor implantation was performed on day 0 with 1 million syngeneic rat mesothelioma cells (IL45-luciferase). Tumors were resected on day 9, followed by treatment with intracavitary cis-fib or vehicle control (NaCl-fib). On day 12, computed tomography-guided local irradiation in a single high dose of the former tumor region was applied.

  Results: We observed only short-term side effects related to 20 Gy radiotherapy. Compared to 20 Gy, 10 Gy IR did not show an impact on tumor growth. At 3 days after treatment with 20 Gy IR (day 15 of the experiment), we detected significantly smaller tumors in the cis-fib+IR group compared to IR alone (mean tumor growth, 252% vs 539%; P = .04). On day 21, there was a significant difference in tumor growth between cis-fib-treated and cis-fib+IR- treated tumors (mean tumor growth, 2295% vs 660%; P = .01).

  Conclusions: Localized treatment after tumor resection in PM aims to improve local tumor control. Irradiation applied in combination with intracavitary cis-fib in rats is safe up to a dosage of 20 Gy and shows an additive effect on tumor growth delay compared to the single treatments.

  © 2024 The Author(s).

• Use of a novel microbiome modulator improves anticancer immunity in a murine model of malignant pleural mesothelioma. C. Gattlen, K.R. Frank, D.N. Marie, et al. 2024;18:324-344. PubMed · Publisher · Free full text

  Abstract

  Objective: Malignant pleural mesothelioma is a fatal disease and a clinical challenge, as few effective treatment modalities are available. Previous evidence links the gut microbiome to the host immunoreactivity to tumors. We thus evaluated the impact of a novel microbiome modulator compound (MMC) on the gut microbiota composition, tumor immune microenvironment, and cancer control in a model of malignant pleural mesothelioma.

  Methods: Age- and weight-matched immunocompetent (n = 23) or athymic BALB/c mice (n = 15) were randomly assigned to MMC or no treatment (control) groups. MMC (31 ppm) was administered through the drinking water 14 days before AB12 malignant mesothelioma cell inoculation into the pleural cavity. The impact of MMC on tumor growth, animal survival, tumor-infiltrating leucocytes, gut microbiome, and fecal metabolome was evaluated and compared with those of control animals.

  Results: The MMC delayed tumor growth and significantly prolonged the survival of immunocompetent animals (P = .0015) but not that of athymic mice. The improved tumor control in immunocompetent mice correlated with increased infiltration of CD3+CD8+GRZB+ cytotoxic T lymphocytes in tumors. Gut microbiota analyses indicated an enrichment in producers of short chain fatty acids in MMC-treated animals. Finally, we observed a positive correlation between the level of fecal short chain fatty acids and abundance of tumor-infiltrating cytotoxic T cells in malignant pleural mesothelioma.

  Conclusions: MMC administration boosts antitumor immunity, which correlates with a change in gut microbiome and metabolome. MMC may represent a valuable treatment option to combine with immunotherapy in patients with cancer.

  © 2024 The Author(s).

• Extended pleurectomy/decortication and hyperthermic intraoperative intrapleural cisplatin perfusion for malignant pleural mesothelioma. K. Okubo, H. Ishibashi, R. Wakejima, et al. 2023;16:977-986. PubMed · Publisher · Free full text

  Abstract

  Objective: To evaluate the efficacy of multimodality treatment including extended pleurectomy/decortication (P/D) and hyperthermic intraoperative chemotherapy (HIOC) with cisplatin for malignant pleural mesothelioma (MPM), we investigated the pharmacokinetics of platinum, adverse events after HIOC, and survival outcome.

  Methods: Fifty-three patients with pathologically diagnosed MPM (cT1-3N0-1M0, excluding sarcomatoid) underwent an extended P/D and HIOC (cisplatin 80 mg/m2 in saline 2 L, 42°C, 60 minutes) since 2011. The protocol includes postoperative 4 cycles of cisplatin and pemetrexed. Platinum concentrations in the perfusate (before and after) and the serum (1, 2, 4, 8, 24, 48, 72 hours after perfusion) were measured in 10 patients. Mortality and morbidity, especially adverse events of renal function, were investigated, and survival and affecting factors were examined.

  Results: All patients obtained macroscopic complete resection and pathologic staging revealed as follows: T1/2/3/4: 12/8/23/10, N0/1: 36/17, stage 1A/1B-3A/3B: 12/31/10, respectively. Platinum concentrations in the perfusate indicated that 28% of the dose remained in the pleural cavity, and the maximum concentration in the serum was 0.91 μg/mL. Six patients (11%) showed elevated max-creatinine (>2 mg/dL) postoperatively. Two patients (4%) received renal-replacement therapy, and one was weaned before discharge. There was no 30-day mortality and one in-hospital death (1.9%). Forty-six patients (87%) received multiple cycles of perioperative systemic chemotherapy. Median overall survival (OS) and disease-free survival (DFS) were 52.4 months and 18.7 months. Patents with stage 1A demonstrated a 5-year OS of 67.3% and a median DFS of 67.1 months, and patients with stage 1B-3A demonstrated a 5-year OS of 50.1% and a median DFS of 20.4 months. Univariate analysis showed histological subtype, p-T, p-stage, and multimodality treatment as significant factors affecting OS. Multivariate analysis revealed histology, p-stage, and multimodality as independent.

  Conclusions: Extended P/D and HIOC with cisplatin for MPM is acceptable with limited acute kidney injury. This multimodality protocol provides promising favorable survival for stage 1A-3A disease.

  © 2023 The Author(s).

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