Less Invasive Multimodal Treatment for Mesothelioma

Less Invasive Multimodal Treatment for Mesothelioma

A less invasive multimodal treatment for mesothelioma can lead to better survival. A team of German researchers discovered this after looking at 20 years of patient data.

Mesothelioma is a rare form of cancer. It most often appears in older adults and is caused by exposure to asbestos. Asbestos is a toxic material that can be found in industrial and consumer products.

Malignant pleural mesothelioma is a specific type of mesothelioma. It develops in the thin layer of tissue that covers the lungs and chest wall. Malignant pleural mesothelioma has three main subtypes: epithelioid, sarcomatoid, and mixed.

Mesothelioma is also an aggressive cancer. It can be hard to treat because symptoms may not show up until decades after the asbestos exposure. The most common treatment strategy is multimodal therapy. This strategy uses more than one type of treatment. This is usually surgery, chemotherapy, and radiation.

Comparing Treatments

This study looked at patients with epithelioid malignant pleural mesothelioma. It compared two types of multimodal treatments. Trimodal extrapleural pneumonectomy (EPP) was one type of treatment. Trimodal EPP uses surgery, chemotherapy, and radiation to treat mesothelioma.

Extended pleurectomy/decortication with hyperthermic intrathoracic chemoperfusion (EPD/HITOC) was the other treatment. This treatment strategy uses surgery and HITOC followed by chemotherapy. This method is more targeted towards the cancerous area, which could lead to better survival rates.

The researchers looked at 182 patient records. These patients had received treatment for epithelioid malignant pleural mesothelioma over a 20-year period at a single hospital. About 38% of patients received trimodal EPP. Thirty-one percent of patients received the less invasive EPD/HITOC. The remaining 31% received only chemotherapy.

The survival rate of the EPD/HITOC patients was over three years. This was longer than the other treatment groups. With more research, this could become the preferred treatment option for eligible mesothelioma patients.


Klotz LV, Hoffmann H, Shah R, et al. Multimodal therapy of epithelioid pleural mesothelioma: Improved survival by changing the surgical treatment approach. Translational Lung Cancer Research. 2022. doi:10.21037/tlcr-22-199

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