Impact of Multimodal Surgical Resection and Personalized Targeted Therapy on Survival Outcomes in Early-Stage Malignant Pleural Mesothelioma: A Meta-Analysis

Cureus 2025 May 22 [Link]

Alexis Quetzalcoatl Vega Morales, Jorge Luis Rivera Gastelum, Alfonso J Massé Ponce, Alexis Agustin A Dunay Silva, Emiliano Banda Dávila, Andrea Virginia Rivera Aguirre, Odalys Brigitte Villares Santillán, Michael David Naranjo Venegas

Abstract

Malignant pleural mesothelioma (MPM) is an aggressive malignancy with limited evaluates the efficacy and safety of these treatments. A systematic review and meta-analysis were conducted, including 14 studies that compared multimodal therapies for early-stage MPM. Continuous variables were analyzed using random-effects modeling, with heterogeneity assessed using I² statistics. The primary outcomes included physical function, social function, and lethargy. The meta-analysis found no statistically significant differences between experimental and control groups in terms of physical function (standardized mean difference [SMD]: -0.34, 95% confidence interval [CI]: -1.14 to 0.45), social function (SMD: 0.01, 95% CI: -0.52 to 0.53), or lethargy (SMD: -0.34, 95% CI: -0.96 to 0.27). Heterogeneity across studies was moderate to high (I²: 47%-76%). These findings suggest limited improvements in quality-of-life domains with experimental approaches compared to controls. This systematic review and meta-analysis highlights the need for individualized, multimodal treatment strategies in MPM management. While extrapleural pneumonectomy and extended pleurectomy/decortication offer specific benefits, their impact on quality of life varies and may not consistently provide significant improvements. Future research should focus on large-scale, randomized trials with standardized protocols to optimize treatment outcomes.