What is the best operating procedure for mesothelioma treatment?

Lung cancer surgery (Credit: Flickr)Main Point:

Scientists have found that Lung-Sparing Surgery called P/D is probably the best surgical treatment as it is better than extrapleural pneumonectomy (EPP) for malignant pleural mesothelioma.

Published in:

Lung Cancer

Study Further:

Extended P/D:

It is a lung sparing surgery in which the pleural lining and other diseased tissues are removed while retaining the lung in place.

Extrapleural pneumonectomy (EPP):

It is lung removing surgery, in which the entire pleural lining, the diseased lung, the lymph nodes, portions of the pericardium surrounding the heart and diaphragm (wholly or partially) are removed. Usually, it is followed by some form of chemotherapy and/or radiotherapy to decrease the chances of any form of mesothelioma cells.

Present Study:

In the present study, scientists worked on six electronic databases of medical studies and found seven relevant studies.

They compared lung-sparing extended P/D with lung-removing EPP for malignant pleural mesothelioma and found that the mortality rate with extended P/D is only 2.9% while with EPP, mortality rate is 6.9%. They also found that rate of complications with P/D is also less than EPP, i.e. 27.9% of P/D patients found serious complications while 60% of patients with EPP experience serious complications. Median overall survival among the studies was also higher with P/D, i.e. 13-29 months, as compared to EPP, i.e. 12-22 months.

“The present study indicated that selected patients who underwent extended P/D had lower perioperative morbidity and mortality with similar, if not superior, long-term survival compared to EPP, in the context of multi-modality therapy. This may represent an important paradigm shift in the surgical management of MPM,” Scientists noted.

Source:

Cao C et al. (2013). A systematic review and meta-analysis of surgical treatments for malignant pleural mesothelioma. Lung Cancer DOI: 10.1016/j.lungcan.2013.11.026

Usman Zafar Paracha

Usman Zafar Paracha is Assistant Professor, Pharmaceutics, in Hajvery University, Lahore, Pakistan.