When it comes to surgery for malignant mesothelioma, patients have few options. The procedure is generally done for either curative purposes – to remove as much cancerous tissue as possible in order to prolong life – or palliative purposes, to remove enough of the disease’s tumors to provide relief from pressure on organs and improve quality of life. The palliative surgery is sometimes performed using what is known as minimally invasive procedures, which involve far smaller incisions and the use of smaller instruments to minimize the trauma to the body. But a recent retrospective study is suggesting that this same procedure could be used more frequently as it provides better short-term outcomes for patients.
Extrapleural Pneumonectomy vs Pleurectomy Decortication
The two types of surgery offered to malignant mesothelioma patients are extrapleural pneumonectomy and pleurectomy/decortication. Of the two the former is far more aggressive, removing a lung and additional tissue. It is most frequently performed on younger and healthier patients, and is associated with a higher rate of cardiovascular complications.
There is debate in the medical community as to which of the two surgeries is superior for overall survival time of mesothelioma patients. While it is theorized that extrapleural pneumonectomy (EPP) offers the better chance at removing all cancerous tissue, the lung-sparing pleurectomy/decortication (P/D) surgery offers lower post-operative morbidity and better quality of life. Statistically, the two have similar survival rates, and as a result the P/D procedure is performed more frequently.
Introducing the Question of Minimally Invasive P/D for Mesothelioma
Though there is a question of whether EPP or P/D surgery offers better outcomes for the treatment of mesothelioma, there’s been little study as to the value of performing the P/D surgery using minimally invasive surgical procedures. A research group from the Thoracic Surgery Department of Icahn School of Medicine at Mount Sinai Health System analyzed data collected from the New York Statewide Planning and Research Cooperative System (SPARCS) gathered between 2007 and 2017. They assessed the outcomes of hundreds of mesothelioma surgeries of both types, including over 115 P/D patients whose surgery was performed using minimally invasive procedures.
The group found that despite the fact that patients offered minimally invasive mesothelioma P/D tended to be older and admitted in urgent/emergent condition, they were less likely than the group that had traditional open surgery to have any complication at all, or to experience a pulmonary complication from the surgery. In their conclusion the researchers write that the minimally invasive procedure “should be considered in the armamentarium of treatment for malignant pleural mesothelioma, especially in older and frailer patients who may not tolerate more radical surgery.”
If you or someone you love has been diagnosed with malignant mesothelioma, it is important that you understand all of the options available to you. For more information, call the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.