Surgical Intervention in Pleural Mesothelioma: A Key to Improved Survival

Surgical Intervention in Pleural Mesothelioma: A Key to Improved Survival

Pleural mesothelioma is a rare, aggressive cancer with a poor prognosis. The impact of surgery on mesothelioma patient survival is unclear and sparking debate.

A recent study was presented at the World Conference on Lung Cancer. It checked the survival of pleural mesothelioma. Some patients had chemotherapy treatments followed by surgery, while other patients skipped surgery. The aim of the study was to see if surgery could help mesothelioma patients live longer.

The Impact of Surgery on Survival

There are a variety of surgical procedures and treatments for pleural mesothelioma. The most recent study, from January 2011 to December 2021, included 296 patients. All were eligible for surgery after three cycles of chemotherapy with platinum plus pemetrexed.

Among them, 272 had the surgery, while 24 refused. Those who had surgery underwent various procedures. These included pleurectomy/decortication, extrapleural pneumonectomy, and exploratory thoracotomy. Those who refused surgery were medically fit but chose not to proceed.

The study found significantly better survival rates in the surgery group. Their median survival was 40.7 months, compared to 23.6 months for the non-surgery group. Similarly, the surgery group’s median survival without progression was 20.2 months, versus 12.9 months for the non-surgery group.

These differences were statistically significant, suggesting surgery improves survival for mesothelioma patients.

Surgery in Multimodal Treatment

The study highlights the importance of surgery for mesothelioma. Surgery aims to remove as much cancer as possible, and it may be part of a treatment plan that includes other therapies.

Doctors often perform cytoreductive surgery in combination with other mesothelioma treatments such as chemotherapy. For example, in a HIPEC procedure (heated intraperitoneal chemotherapy), surgeons introduce heated chemotherapy directly into the surgical cavity. In the peer reviewed medical literature, HIPEC procedures used in peritoneal mesothelioma management report superior survival statistics when compared to other surgeries.

Immune checkpoint inhibitors also show promise for advanced mesothelioma. But, early cases rely on surgery, chemotherapy, and radiotherapy. Past studies suggest surgery with chemotherapy can extend mesothelioma patients’ lives.

The latest research shows that surgery can improve survival in mesothelioma patients. While further research is needed to confirm these findings, this study adds to the growing body of evidence supporting the role of surgery in the multimodal treatment of pleural mesothelioma.


Rusch, Valerie W. “Surgical Resection for Pleural Mesothelioma: Is It All about Patient Selection?” The Annals of Thoracic Surgery, April 6, 2024.

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