Surgical Therapy of Mesothelioma

摘要: The treatment of malignant pleural mesothelioma is controversial, particularly regarding the role surgery. Though well accepted as a diagnostic modality, surgery also frequently used to establish stage, provide palliation, and perhaps most controversially, offer cytoreduction with putative goal delaying tumor progression prolonging survival. Pleurectomy/decortication (PD) can achieve macroscopic complete resection; however, ability deliver effective postoperative radiation limited because risk lung toxicity. Accordingly, it has been associated higher rates local recurrence compared extrapleural pneumonectomy (EPP). Extrapleural generally offers more PD but at cost increased morbidity mortality. Adjuvant hemithoracic feasible following EPP in series are lower after than PD. There no convincing data, show that one procedure superior other terms Furthermore, randomized data currently exist demonstrate survival benefit any form surgical over systemic supportive care. If cytoreductive does have beneficial effect on long-term survival, will likely be realized patients epithelioid tumors without nodal metastases.