Title
Surgery in mesothelioma : where do we go after MARS? Surgery in mesothelioma : where do we go after MARS?
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Hagerstown, Md :Lippincott Williams & Wilkins ,
Subject
Human medicine
Source (journal)
Journal of thoracic oncology / International Association for the Study of Lung Cancer [Aurora, Colo.] - Hagerstown, Md, 2006, currens
Volume/pages
8(2013) :5 , p. 525-529
ISSN
1556-0864
ISI
000317582000014
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
The role of surgery in the management of malignant pleural mesothelioma remains controversial. Surgical resection consists of different procedures for diagnostic or therapeutic reasons. The latter includes either an extrapleural pleuropneumonectomy (EPP) or lung-sparing operations like debulking of the parietal and visceral pleura by pleurectomy/decortication (P/D) or extended pleurectomy/decortication, in which further debulking of the diaphragm or pericardium is included. Because of the modest outcome of surgery as single-modality therapy, combinations of chemotherapy, surgery, and radiation therapy were initiated as a new treatment strategy to improve prognosis. The observations that patients treated with P/D had an equal to better outcome than those treated with EPP, and that EPP with perioperative chemotherapy was better than EPP alone, raises the issue whether performing a P/D with perioperative chemotherapy would result in a further improvement of outcome with a lower operative mortality than with EPP and perioperative chemotherapy. This is the rationale for the next European Organisation for Research and Treatment of Cancer trial exploring the feasibility of P/D with perioperative chemotherapy.
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