Significant Mesothelioma Medical Finding

Suggested Possible Change in Surgical Procedures for Malignant Mesothelioma

A study just published in the April 2012 issue of the Journal of Thoracic Oncology suggests that the preferred surgery for pleural mesothelioma patients is a procedure in which surgeons remove the diseased lining around the lung and have less impact on the lung itself. The surgery is known as a pleurectomy/decortication or P/D. It is less extensive than the common alternative surgery used to treat mesothelioma patients.
The two surgical alternatives for mesothelioma are pleurectomy/decortication, above-referenced and a more radical procedure known as an extrapleural pneumonectomy or EPP. Using EPP procedures, surgeons remove the entire diseased lung, the lining of the lung, part of the membrane covering the heart and part of the diaphragm.

Extrapleural pneumonectomy was considered the standard surgery procedure for mesothelioma. The new research presented in the medical journal of the International Association for the Study of Lung Cancer concludes that patients who underwent a pleurectomy/decortication had better results than those who underwent more extensive surgery, based on a recent analysis. The researchers studied about 75 mesothelioma patients who underwent either of the two surgical procedures between January 2008 and June 2011.

The researchers observed that 4.5 percent of 22 patients who underwent an extrapleural pneumonectomy, the radical procedure, died within a month compared to none in the group who had the less extensive procedure. Mesothelioma victims who had an EPP also had a higher rate of health complications.

Two years after the procedure, nearly fifty percent of the patients who had a pleurectomy/decortication were alive compared to 18 percent of those who had EPP, according to the research. Nearly three out of ten of the patients had a pleurectomy/decortication were alive compared to 9 percent who had EPP.

The authors led by Dr. Loïc Lang-Lazdunski, head of the mesothelioma treatment program at Guy’s Hospital in London, propose that pleurectomy/decortication become the standard of treatment in combination with chemotherapy.

Dr. Michael Weyant, a thoracic surgeon and assistant professor at the University of Colorado, in an editorial writes that the “results of the current study by Lang-Lazdunksi et al provide additional data that should lead us to consider P/D in all trials of treatment for malignant pleural mesothelioma. It is too early based on this data to completely abandon EPP altogether as there may be patient subsets where the potential reward outweighs the risks of the procedure.”

Those patients treating for malignant mesothelioma should share this information with their doctor.