Mesothelioma surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed. It is not possible to remove the entire mesothelium without killing the patient.
- Pleurodesis and pleurectomy can be used to manage bothersome effusions
- Radical pneumonectomy with removal of the lung, pleura, pericardium, phrenic nerve and the hemidiaphragm has an almost 35% operative mortality, but with adjuvant chemotherapy and radiation may prolong survival and palliate severe dyspnea
Median survival increased from 16 to 24 months