Though malignant pleural mesothelioma remains one of the most challenging types of cancer to treat, physicians continue to refine surgical approaches and improve patient outcomes. A recently conducted retrospective study has confirmed the benefits of extended pleurectomy decortication as a surgical approach in the treatment of the rare, asbestos-related disease, indicating that patients who opt for this approach have a low risk of postoperative mortality. The study confirms that the surgery leads to prolonged overall survival when successful removal of all cancerous tissue is achieved.
Combination Surgery/Systemic Treatment Continues to Offer Best Hope for Mesothelioma
The study was published in the Annals of Surgery and was a retrospective chart review of the records of 355 consecutive patients with malignant pleural mesothelioma. The patients had all been treated at a single facility between 2007 and 2015. All underwent thoracotomy for planned pleurectomy decortication and were evaluated for both short and long-term outcomes, as well as associated prognostic factors.
Pleurectomy decortication is a lung-sparing surgery that removes the pleura and visible tumor masses, while the extended version of the surgery also removes the pericardium and part of the diaphragm. Both procedures are considered less invasive than extrapleural pneumonectomy, a mesothelioma surgery that removes all of these organs as well as the lung. In all cases the surgery is recommended to be used in combination with systemic approaches to address metastatic disease and optimize outcomes.
Study Shows Minimal Complications
The results of the study were encouraging for mesothelioma patients opting for the lung-sparing surgery. Most patients experienced only low-grade complications, with a thirty-day mortality of 3% and a 90-day mortality of 4.6%. The most striking difference in overall survival existed between those for whom the surgery successfully removed all malignant tissue, with a median overall survival of 23.2 months, while for those whose surgery did not remove all malignancies the overall median survival was just 11.6 months. Other factors shown to negatively impact survival were male vs female and higher tumor stage, while use of chemotherapy, intraoperative heated chemotherapy and epithelioid histology were shown to positively impact survival.
If you have been diagnosed with malignant mesothelioma and need more information on treatment options and other resources, the Patient Advocates at Mesothelioma.net can help. Contact us today at 1-800-692-8608.