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Is it Time to Consider Pleurectomy and Decortication as the Only Surgical Treatment for Malignant Pleural Mesothelioma?

Is it Time to Consider Pleurectomy and Decortication as the Only Surgical Treatment for Malignant... EDIToRIAL Is it Time to Consider Pleurectomy and Decortication as the Only Surgical Treatment for Malignant Pleural Mesothelioma? Michael J. Weyant, MD adical extrapleural pneumonectomy (EPP), and pleurectomy and decortication (P/D) Rhave emerged as the two main surgical treatments of malignant pleural mesothelioma (MPM). Until recently, EPP has been considered the gold standard operation with P/D being performed if the patient’s physical status or preference dictated it. The operative mortality of EPP is reported to be as high as 18% in some series that has generated interest in studying the P/D procedure more intensively because of lesser complications and pos- sibly better survival rates reported. Flores et al. reported on a series of 663 patients who underwent either EPP or P/D as part of their treatment for MPM . This is the largest series to date examining the outcomes of P/D as a modality of treatment for MPM. Their results demonstrate that there may be circumstances, such as in stage-I disease where an R0 resec- tion is attained, in which P/D is a superior, less-morbid therapy. Likewise there may be a benefit to EPP in patients who have more extensive disease (stage II). This data suggests that the main http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Thoracic Oncology Wolters Kluwer Health

Is it Time to Consider Pleurectomy and Decortication as the Only Surgical Treatment for Malignant Pleural Mesothelioma?

Journal of Thoracic Oncology , Volume 7 (4) – Apr 1, 2012

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Copyright
Copyright © 2012 by the International Association for the Study of Lung Cancer
ISSN
1556-0864
DOI
10.1097/JTO.0b013e31824d9a52
pmid
22425910
Publisher site
See Article on Publisher Site

Abstract

EDIToRIAL Is it Time to Consider Pleurectomy and Decortication as the Only Surgical Treatment for Malignant Pleural Mesothelioma? Michael J. Weyant, MD adical extrapleural pneumonectomy (EPP), and pleurectomy and decortication (P/D) Rhave emerged as the two main surgical treatments of malignant pleural mesothelioma (MPM). Until recently, EPP has been considered the gold standard operation with P/D being performed if the patient’s physical status or preference dictated it. The operative mortality of EPP is reported to be as high as 18% in some series that has generated interest in studying the P/D procedure more intensively because of lesser complications and pos- sibly better survival rates reported. Flores et al. reported on a series of 663 patients who underwent either EPP or P/D as part of their treatment for MPM . This is the largest series to date examining the outcomes of P/D as a modality of treatment for MPM. Their results demonstrate that there may be circumstances, such as in stage-I disease where an R0 resec- tion is attained, in which P/D is a superior, less-morbid therapy. Likewise there may be a benefit to EPP in patients who have more extensive disease (stage II). This data suggests that the main

Journal

Journal of Thoracic OncologyWolters Kluwer Health

Published: Apr 1, 2012

References