Is malignant pleural mesothelioma a surgical disease? A review of 83 consecutive extra-pleural pneumonectomies☆☆☆

Abstract

These results concur with the published data of the most experienced centre with regards to the mortality and morbidity after EPP for MPM. In line with the biggest series reported in the past, the observed 5-year survival rate of almost 15% is disappointing.

Can hyperthermic intrathoracic perfusion chemotherapy added to lung sparing surgery be the solution for malignant pleural mesothelioma?

“…Thus majority of pleural resections including EPP are accepted as at least R1 resection and adjuvant radiotherapy and postoperative chemotherapy are needed. [1,[3][4][5][6][7][8] Therefore, it is reasonable to accept that adjuvant therapy would provide better survival in MPM subjects who undergo cytoreductive surgery plus HIPEC.…”

“…Unfortunately, standard treatment modalities are insufficient to cure MPM. [1,[3][4][5][6][7][8] Therefore, researchers have been striving to find other treatment modalities. [10][11][12][13] Hyperthermic perfusion of pleural space is one of these methods.…”

“…Most authors agree on trimodality therapy in MPM. [1,[3][4][5][6][7][8] Particularly surgery has an important role in reducing tumor volume. Thus, a treatment modality without surgery does not appear to be effective.…”

“…Moreover, its incidence has been increasing since 10 to 15 years due to environmental and occupational asbestosis. [1,2] Particularly in our country, there are areas where asbestos can be found in 54 of 81 provinces and at least 1,000,000 people are living in rural areas just near asbestos locations or using asbestos in their houses for water and cold isolation. [2] Although asbestos trading and usage in industrial branches have been forbidden since 2010 in Turkey, because of asbestos exposure before this date, it is expected that MPM cases will increase in 20 years.…”

“…In the past 35 years, there has been no satisfactory improvement in survival related to MPM. [1,[3][4][5][6][7] At least three different treatment modalities are used including surgery, chemotherapy, or radiation therapy to obtain best survival time. Surgery aims to deliver a R0 resection.…”