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Apollo Proton Cancer Centre treats Asia’s First Radical Pleurectomy surgery with HITOC on adolescent with Ewing’s Sarcoma

The treatment of radical surgery with HITHOC is the first of its kind in Asia for an adolescent

Apollo Proton Cancer Centre (APCC) performed Asia’s first Radical pleurectomy with HITHOC (Hyperthermic intrathoracic chemotherapy) on a 16-year-old adolescent from Kerala.

In line with providing comprehensive and the most advanced cancer care in India, Apollo Proton Cancer Centre treated an unusual case with multi-step surgery involving pericardiectomy, wedge resection of the left lung and en-bloc resection of the intrathoracic mass with HITHOC.

In early 2020, a 16-year-old adolescent was detected to have Ewing’s Sarcoma of the left intra-thoracic cavity for which the patient underwent neo-adjuvant chemotherapy followed by surgery and radiation with maintenance chemotherapy. Post-treatment the recurrence of the cancer was deducted within six months, the patient approached APCC, Chennai for further treatment. The team of clinicians examined the case and conducted tests to chart out the multi-step surgery and treatments for the unique case.

The treatment performed by Dr Khader Hussain, Consultant, Surgical Oncologist (Thoracic) & Robotic Surgeon and Dr Abhijit Das, Consultant, Surgical Oncologist (Thoracic) & Robotic Surgeon,  consisted of Radical pleurectomy, pericardiectomy, wedge resection of the left lung, en bloc resection of the intrathoracic mass followed by HITHOC (Hyperthermic intrathoracic chemotherapy). This treatment of radical surgery with HITHOC is the first of its kind in Asia for an adolescent.

Dr Khader Hussain, Consultant, Surgical Oncologist (Thoracic) & Robotic Surgeon, Apollo Proton Cancer Centre, said, “When APCC was approached for this unique case of Ewing’s Sarcoma (a rare type of cancer that occurs in bones or the soft tissue around the bones), we analysed the patient and concluded that this was the first such case with multiple challenges in an adolescent. The cancer was in the left intra- thoracic region and had recurred within five months of the first treatment. The tumour board carefully diagnosed and created the surgery plan where in Radical pleurectomy was conducted with HITHOC- Hyperthermic intrathoracic chemotherapy. This radical surgery plus HITHOC is a first of its kind for adolescents. It is generally done for adult patients. This technology has the potential to revolutionize the treatment of certain primary and secondary pleural malignancies. The patient recovered in 3 weeks and is being examined regularly to keep a check on recurrence again at present the patient is disease free for one year and he is resumed high school.”

Dr Abhijit Das, Consultant, Surgical Oncologist (Thoracic) & Robotic Surgeon, Apollo Proton Cancer Centre, “Post close diagnosis, we concluded that the thoracic region was majorly affected due to Ewing’s Sarcoma. Though the disease has damaged many parts of that region, we deemed it fit to construct a detailed plan for surgery involving a multidisciplinary team to ensure the complete removal of cancer and decrease the chances of recurrence to a minimum. Treating this case with our experience of more than 10 such cases in adults, made us take the right steps to lead the patient on road to recovery. The patient has recovered well and is regularly diagnosed with no signs of cancer recurrence at present.”

Harish Trivedi, Chief Executive Officer, Apollo Proton Cancer Centre, said, “On this unique win, I would like to congratulate the team on the successful surgery to address Ewing’s Sarcoma in the thoracic region. Strengthening the Apollo Pillars of Expertise and Excellence, APCC brings together a powerful team of clinicians renowned in cancer care to treat such challenging cases. The well-thought approach and advanced care helped in turning the case around in the favour of the patient.”

Multidisciplinary care at APCC is the hallmark of high-quality cancer management. Multi-Disciplinary Tumour Board has specialists from surgery, medical oncology, radiation oncology, radiology, genetics, and pathology collaboratively review a patient’s condition and determine the best treatment plan. Through this approach, patients have access to a diverse team whose opinion is evidence-based and comprehensive keeping in mind the various needs of the patient.

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