Monday, December 7, 2015

From Hyogo College of Medicine, Japan: Current surgical strategies for malignant pleural mesothelioma

 2015 Nov 21. [Epub ahead of print]

Current surgical strategies for malignant pleural mesothelioma.

Author information

  • 1Hyogo College of Medicine, 1-1Mukogawacho Nishinomiya, Hyogo, 663-8501, Japan. ttakuwa@hyo-med.ac.jp.
  • 2Hyogo College of Medicine, 1-1Mukogawacho Nishinomiya, Hyogo, 663-8501, Japan.

Abstract

Malignant pleural mesothelioma (MPM) is associated with a poor prognosis. The main components of multimodality treatment include surgery, chemotherapy, and radiation therapy. Surgery remains controversial. Two procedures are currently offered: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). The recent scientific literature suggests that P/D is a well-tolerated procedure, with the potential of becoming a default procedure in multimodality regimens. However, the precise treatment schemes and surgical procedures are yet to be established. In our study, we review the advantages and disadvantages of EPP and P/D, summarize the post-EPP and post-P/D observations (including mortality, morbidity, and median survival time), and discuss the choice of surgical technique (EPP vs. P/D). Moreover, we highlight the aspects of the multimodality treatments that are offered to MPM patients, including chemotherapy, radiotherapy, intensity-modulated radiation therapy, and other types of therapy.

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