title: Current surgical strategies for malignant pleural mesothelioma.
abstract: Malignant pleural mesothelioma (MPM) is associated with a poor prognosis. The main components of multimodality treatment include surgery, chemotherapy, and radiation therapy. Surgery remains controversial. Two procedures are currently offered: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). The recent scientific literature suggests that P/D is a well-tolerated procedure, with the potential of becoming a default procedure in multimodality regimens. However, the precise treatment schemes and surgical procedures are yet to be established. In our study, we review the advantages and disadvantages of EPP and P/D, summarize the post-EPP and post-P/D observations (including mortality, morbidity, and median survival time), and discuss the choice of surgical technique (EPP vs. P/D). Moreover, we highlight the aspects of the multimodality treatments that are offered to MPM patients, including chemotherapy, radiotherapy, intensity-modulated radiation therapy, and other types of therapy.
authors.affiliation: Hyogo College of Medicine, 1-1Mukogawacho Nishinomiya, Hyogo, 663-8501, Japan. ttakuwa@hyo-med.ac.jp.
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Takuwa
authors.affiliation: Hyogo College of Medicine, 1-1Mukogawacho Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Seiki
authors.initials: S
authors.lastname: Hasegawa
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D060828:Induction Chemotherapy; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008654:Mesothelioma / Q000473:pathology / Q000601:surgery*; D000086002:Mesothelioma, Malignant; D009367:Neoplasm Staging; D010994:Pleura / Q000601:surgery*; D010997:Pleural Neoplasms / Q000473:pathology / Q000601:surgery*; D011013:Pneumonectomy / Q000379:methods* / Q000639:trends*; D050397:Radiotherapy, Intensity-Modulated; D019616:Thoracic Surgical Procedures / Q000379:methods* / Q000639:trends*
keywords: Extrapleural pneumonectomy; Malignant pleural mesothelioma; Pleurectomy/decortication; Surgical therapy