Though all physicians treating patients with mesothelioma have the same goal of providing their patients with the best possible outcome and longest possible survival, there are disagreements about how that should be achieved. Most agree that patients do best with a combination of surgery and other modalities such as chemotherapy and radiation therapy, but where they differ is on the type of surgery that patients should have: while some believe that surgery should be aggressive, even going so far as to remove an impacted lung, others believe that this approach compromises patient health and subjects them to the risk of too many complications. Though there are studies that support both sides of this disagreement, one of the most recent will prop up those who argue for the more aggressive surgery known as extra pleural pneumonectomy.
The mesothelioma study was conducted by researchers at University Hospitals KU Leuven in Belgium and was published in the European Journal of Cardio-Thoracic Surgery. The group followed almost 200 mesothelioma patients who were treated between 2003 and 2014, some of whom were treated with the radical surgery and others who were not. What they found was that when EPP was combined with chemotherapy and radiation therapy on patients who were under the age of 70 and in otherwise good health, almost 25% had survived at least five years after the combination therapy. This represents a far greater survival than that of the average mesothelioma patient, who lives just 18 months after diagnosis. Still, the researchers hasten to acknowledge that part of the success rate that they recorded was a result of the patients’ relative youth and good health, which helped them overcome the rigors of the more aggressive lung-removing surgical procedure. The researchers also noted that the patients whose mesothelioma had been identified as being of the epithelioid subtype and whose cancer had not spread to their lymph nodes had a marginally better survival rate than patients diagnosed with other subtypes.
The mesothelioma study included the medical records of 197 patients, almost half of whom began their treatment protocols with chemotherapy. Out of 76 who had surgery, 56 chose the more aggressive EPP procedure over lung-sparing surgery, and of the 76, 47 also went on to finish the combination therapy protocol by undergoing radiation therapy. Of those 47 who pursued the complete course of three therapies, 24 % were still alive five years later.
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