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Extrapleural pneumonectomy for diffuse, malignant mesothelioma.

M J DaValle, L P Faber, C F Kittle

    The Annals of Thoracic Surgery
    |December 1, 1986
    PubMed
    Summary
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    Extrapleural pneumonectomy offers palliation for malignant mesothelioma patients, with 24% achieving good symptom relief and some experiencing long-term survival. This radical surgery involves removing surrounding tissues, and can be performed with acceptable risks.

    Area of Science:

    • Thoracic Surgery
    • Surgical Oncology
    • Mesothelioma Research

    Background:

    • Malignant mesothelioma is a rare and aggressive cancer.
    • Extrapleural pneumonectomy (EP) is a major surgical intervention for this disease.
    • Patient selection is crucial for optimizing outcomes.

    Purpose of the Study:

    • To evaluate the efficacy and safety of extrapleural pneumonectomy for malignant mesothelioma.
    • To assess rates of palliation and long-term survival following EP.
    • To analyze operative outcomes, including morbidity and mortality.

    Main Methods:

    • Retrospective analysis of 33 patients undergoing extrapleural pneumonectomy for diffuse malignant mesothelioma.
    • Data collected included patient demographics, asbestos exposure history, tumor histology, surgical side, and postoperative outcomes.

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  • Palliation defined as survival >24 months with return to normal activities; long-term survival also assessed.

    • Main Results:

    • 33 patients (27 male, 6 female) underwent EP; 16 (48%) had asbestos exposure history.
    • Histology: 20 epithelial, 10 mixed, 3 sarcomatous.
    • Good palliation achieved in 8 patients (24%); 5 patients survived >36 months, with 3 surviving >59 months.
    • Operative mortality was 9.1% (3 deaths); 24% (8 patients) experienced serious postoperative complications.

    Conclusions:

    • Extrapleural pneumonectomy for malignant mesothelioma can be performed with acceptable morbidity and mortality.
    • The procedure provides good palliation in 24% of patients.
    • Occasional long-term survivors are possible following this radical surgical approach.