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Extrapleural pneumonectomy for diffuse malignant pleural mesothelioma: techniques and complications
Michael Y Chang1, David J Sugarbaker
1Division of Thoracic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Thoracic Surgery Clinics
|November 24, 2004
Summary
Innovative treatments like chemotherapy and gene therapy show promise for mesothelioma. Strategies focusing on local control after surgery may improve survival rates for this lethal disease.
Area of Science:
- Oncology
- Thoracic Surgery
Background:
- Malignant mesothelioma is a lethal disease with limited treatment options.
- Recurrence after surgical resection is often locoregional, highlighting the need for improved local control strategies.
Purpose of the Study:
- To review innovative therapeutic agents and strategies for improving survival in malignant mesothelioma.
- To discuss advancements in surgical resection techniques, including extrapleural pneumonectomy (EPP).
Main Methods:
- Investigation of novel chemotherapy agents such as gemcitabine and pemetrexed.
- Exploration of emerging therapies including cytokines, suicide gene therapy, and photodynamic therapy.
- Evaluation of intraoperative intracavitary lavage with hyperthermic chemotherapy post-EP.
Main Results:
- Gemcitabine and pemetrexed demonstrate promise in treating mesothelioma.
- Novel therapies are being explored to target mesothelioma effectively.
- Surgical resection techniques for mesothelioma have significantly improved, with EPP showing acceptable outcomes at experienced centers.
Conclusions:
- Despite challenges, advancements in surgical techniques and the development of novel therapeutic strategies offer hope for improved outcomes in mesothelioma treatment.
- Focusing on local control post-surgery is crucial for enhancing patient survival.