Tag Archives: extrapleural pneumonectomy

Surgeons Disagree on Definition of Mesothelioma Surgery

When surgery is indicated for mesothelioma, doctors typically turn to one of two procedures: extrapleural pneumonectomy or pleurectomy/decortication (P/D). Of the two, extrapleural pneumonectomy is the most extensive and risky, involving removal of a lung, the lining of the lung, and parts of the diaphragm. Though somewhat controversial, this mesothelioma surgery is well-defined in most centers. In contrast, a new study finds that surgeons vary widely in their definition of pleurectomy/decortication. To get a better understanding of what mesothelioma surgeons mean when referring to P/D, members of the International Association for the Study of Lung Cancer and the International Mesothelioma Interest Group conducted a web-based survey of 62 surgeons from 39 medical centers who had performed at least one mesothelioma … Continue reading Surgeons Disagree on Definition of Mesothelioma Surgery »

Predicting Long-Term Mesothelioma Survival After Surgery

Most mesothelioma  patients and their families have heard the poor survival statistics associated with this aggressive cancer. But two new studies on two different types of mesothelioma suggest that long term survival is possible with surgery and can even be predictable. The first study was a multi-center analysis conducted in Italy between 2000 and 2010. Researchers retrospectively reviewed the cases of 468 malignant pleural mesothelioma patients who underwent extrapleural pneumonectomy – a radical surgery that involves removing the diseased pleural lining as well as the closest lung. Since most pleural mesothelioma patients die within a year of diagnosis, the research team classified those who lived three years or longer as “long term survivors.” A total of 107 mesothelioma patients (22.9%) fell into … Continue reading Predicting Long-Term Mesothelioma Survival After Surgery »

Study Defends Use of Radical Surgery for Mesothelioma

A new study says the controversial extrapleural pneumonectomy procedure for mesothelioma can be performed with “acceptable morbidity and mortality”, as long as certain guidelines are followed. Extrapleural pneumonectomy (EPP) is a large and complex procedure that involves removing a mesothelioma patient’s lung, lung lining, diaphragm and other tissues in an effort stop the spread of mesothelioma. Although some studies have indicated a mesothelioma survival benefit with EPP, the procedure has come under fire because of its high rate of death and complications. But the new EPP study suggests that it can be performed safely. The study evaluated the cases of 251 mesothelioma patients from three high-volume hospitals – University Hospital Zurich in Switzerland, Medical University Vienna in Austria, and Toronto … Continue reading Study Defends Use of Radical Surgery for Mesothelioma »

EPP No, Chemotherapy Yes, Suggests New Mesothelioma Study

A pair of thoracic oncologists from Belgium say it’s time to go a step further in the wake of a controversial study on mesothelioma surgery and examine the impact of perioperative chemotherapy. Based on mesothelioma research from around the world, the 2011 Mesothelioma and Radical Surgery (MARS) randomized feasibility study concluded that extrapleural pneumonectomy (EPP) was too risky and should be abandoned as a surgical approach for mesothelioma. EPP involves removing not only the diseased pleura containing the mesothelioma tumor, but also the nearest lung, the diaphragm, and other internal membranes.  The MARS study recommended, instead, that operable mesothelioma be treated with lung-sparing pleurectomy/decortication (P/D) or extended pleurectomy/decortication. But surgery alone, regardless of which method is used, has been shown to produce … Continue reading EPP No, Chemotherapy Yes, Suggests New Mesothelioma Study »

New Radiotherapy Technique May be Safer for Mesothelioma

There’s more evidence that an advanced method for delivering radiotherapy may improve survival for mesothelioma patients after surgery. Extrapleural pneumonectomy (EPP) is a surgical procedure for malignant pleural mesothelioma that involves removing the mesothelioma tumor, as well as the pleural lining where the tumor is located, the nearest lung, all or part of the diaphragm, and other internal membranes. It is often followed by adjuvant radiotherapy to kill remaining tumor cells. Because the radiation target area in post-operative mesothelioma patients is irregular in shape and located close to critical internal organs, many patients receive a targeted type of radiotherapy called intensity modulated radiation therapy (IMRT). But postoperative IMRT also carries a high risk of a potentially fatal lung condition called … Continue reading New Radiotherapy Technique May be Safer for Mesothelioma »

Radiotherapy and EPP is a Winning Combo for Some Mesothelioma Patients

Another study has confirmed the value of radiotherapy as an adjuvant treatment for mesothelioma patients who undergo extrapleural pneumonectomy. A team of Italian researchers recently analyzed the records of 56 mesothelioma patients who had been treated with adjuvant radiotherapy after extrapleural pneumonectomy surgery (EPP) between 2005 and 2010. Caused by exposure to asbestos, malignant mesothelioma is a fast-growing cancer of the mesothelial lining around the lungs and other organs. Extrapleural pneumonectomy is a radical surgical procedure that involves removing not only the mesothelioma tumors, but also the lung closest to the tumor and a portion of the diaphragm. Although EPP is controversial due to its high rate of complications, a number of studies have shown it to increase survival, especially … Continue reading Radiotherapy and EPP is a Winning Combo for Some Mesothelioma Patients »

Open Biopsy Better for Diagnosing Mesothelioma Subtype

Open surgical biopsy – called thoracotomy – appears to be the best way to get an accurate diagnosis of mesothelioma subtype. Mesothelioma is a fast-growing malignancy caused by asbestos exposure.  Epithelial mesothelioma is the most common subtype, followed by sarcomatoid and biphasic.  Determining which subtype a patient has is an important prognostic indicator and can help guide doctors in making treatment decisions. But mesothelioma itself is notoriously difficult to diagnose, and determining subtype can be equally tricky. To help determine the most accurate diagnostic method, a group of Australian scientists evaluated the records of 83 patients who underwent a surgical procedure called extrapleural pneumonectomy (EPP) for mesothelioma between 1994 and 2009. A panel of pathologists reviewed the specimens collected during EPP and … Continue reading Open Biopsy Better for Diagnosing Mesothelioma Subtype »

For Select Mesothelioma Patients EPP Improves Survival

A new study has confirmed the value of the surgical approach known as extrapleural pneumonectomy (EPP) for the treatment of malignant pleural mesothelioma in select patients. The pleural membrane separates the lungs from other internal organs. Pleural mesothelioma starts in the pleural tissue where it can cause the membrane to thicken and stiffen, restricting the ability of the lungs to expand. Eventually, the pleural cancer may metastasize into the lungs and other internal membranes. Extrapleural pneumonectomy attempts to prevent the mesothelioma cancer from further spreading to other parts of the body cavity by removing the tissues most likely to be effected. During an extrapleural pneumonectomy, the surgeon removes part of the parietal pleura, or lung lining, as well as part … Continue reading For Select Mesothelioma Patients EPP Improves Survival »

Mesothelioma Recurrence Treated With Second Surgery

When pleural mesothelioma returns after treatment, attacking it with a second round of surgery can provide symptom relief, but no real hope for a cure, according to a recent study published in the January Annals of Thoracic Surgery. Doctors frequently treat pleural mesothelioma with a radical surgery called extrapleural pneumonectomy (EPP), which removes parts of the diseased lung, lung lining, heart lining, and diaphragm. Yet even with this aggressive approach, the cancer often returns. A second surgery can be performed, but no study has yet determined whether patients actually benefit from the additional procedure. To determine what, if any, benefit a second surgery might have for patients whose cancer has returned, researchers in Italy reviewed the medical records of 74 … Continue reading Mesothelioma Recurrence Treated With Second Surgery »

Mesothelioma and the Immune System

The presence of an immune cell is associated with better prognosis for patients undergoing extrapleural pneumonectomy for malignant pleural mesothelioma is the conclusion of a recent article published in the Journal of Thoracic Cardiovascular Surgery.1 Canadian researchers tested mesothelioma samples removed from 32 patients (28 men and 4 women). The patients ranged in age from 21 to 74 (median age was 59). The researchers were looking for the numbers of specific types of immune cells. They then compared this data to the survival of the patients to see if these cell counts had any relationship with survival. They found that one specific type of immune cell called CD8+ was associated with better prognosis. The study found that higher levels of … Continue reading Mesothelioma and the Immune System »