Surgical Treatment Options for Mesothelioma

For some patients with mesothelioma, aggressive surgical treatment can help them live longer than other treatment options.

This is the finding of a study published in the Journal of Thoracic and Cardiovascular Surgery. The authors focused on a specific type of surgery called “cytoreductive surgery” that is done in both the chest and belly area.

Surgery Provides Hope for Cure

Mesothelioma is a deadly cancer caused by asbestos exposure. The type of treatment for mesothelioma depends on many factors. The location of the cancer, the type of mesothelioma, and the health of the patient are some of these key factors.

For patients who are healthy enough, surgery provides the best hope for a cure. Cytoreductive surgery is a type of procedure that aims to remove all cancerous tissue. When mesothelioma grows in the lungs, this type of surgery can either be “extrapleural pneumonectomy” (EP) or “extended pleurectomy/decortication” (ePD).

When a patient has an EP procedure, as much of the affected lung tissue is removed as possible. Sometimes the entire lung is removed to get rid of all cancer cells. With an ePD procedure, the doctor tries to leave as much of the lungs in place as possible.

Aggressive Surgical Options

The scientists in this study looked at medical records of 440 patients with mesothelioma who had a cytoreductive surgery between 2014 and 2021. They found that out of these 440 patients, only 14 had the surgery in both the chest and belly and most of them had the chest surgery first.

The scientists found that the average survival time for all patients was 33.6 months and that 5 years after diagnosis, 20% of patients were still alive.

They also found that patients who had ePD had better survival than patients who had EP. Patients who had an ePD procedure had an average survival time of 58.2 months. Patients who had EP had an average survival time of only 13.5 months.

The conclusion of the study is that for a small group of patients with mesothelioma in both the chest and belly, they can live longer with aggressive surgery. The study also showed that patients who have ePD surgery, which tries to preserve the lung, had better results compared to the EP surgery, which removes the lung.

Source

Ripley RT, Holmes HM, Whitlock RS, et al. Pleurectomy and decortication are associated with better survival for bicavitary cytoreductive surgery for mesothelioma compared with extrapleural pneumonectomy [published online ahead of print, 2022 Dec 14]. J Thorac Cardiovasc Surg. 2022;S0022-5223(22)01338-1. doi:10.1016/j.jtcvs.2022.11.035. https://pubmed.ncbi.nlm.nih.gov/36740497/