Surgery for malignant pleural mesothelioma

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations

Abstract

Controversy remains regarding the optimal therapy for MPM. In fit patients with epithelioid tumors and negative nodes, cytoreductive surgery combined with appropriate adjuvant or neoadjuvant therapy may improve survival compared to best supportive care or chemotherapy alone, although this is unproven. An ongoing randomized trial is currently underway in the United Kingdom that will compare trimodality therapy including EPP to trimodality therapy without EPP [33]. Complete removal of all macroscopic disease should be the goal of any potentially curative surgical procedure, whether EPP or P/D. Extrapleural pneumonectomy has been associated with lower rates of local recurrence, particularly when combined with high-dose hemithoracic radiation; however, it has also been associated with higher perioperative morbidity and mortality in comparison to P/D. Currently, there is no convincing evidence of any survival difference between the 2 procedures. Distant failure remains a significant issue that limits long-term survival in patients who have undergone EPP. However, if distant metastatic disease could be prevented in the future, then the local control of achievable with EPP might translate into improved survival.

Original languageEnglish (US)
Pages (from-to)65-72
Number of pages8
JournalAnnals of Diagnostic Pathology
Volume13
Issue number1
DOIs
StatePublished - Feb 2009

Keywords

  • Extrapleural pneumonectomy
  • Malignant pleural mesothelioma
  • Surgery

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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