[Malignant Pleural Mesotheliomas]

C Biancosino1, B Redwan1, M Krüger2

  • 1Klinik für Thoraxchirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten-Herdecke, Wuppertal, Deutschland.

Zentralblatt Fur Chirurgie
|September 10, 2016
PubMed

Insights

Malignant pleural mesothelioma (MPM) is an aggressive asbestos-linked cancer. Diagnosis requires tissue samples, and multi-modal treatment is superior, with a shift towards radical pleurectomy (RP) over extrapleural pneumonectomy (EPP).

Area of Science:

  • Oncology
  • Thoracic Surgery
  • Pathology

Background:

  • Malignant pleural mesothelioma (MPM) is an aggressive cancer originating from pleural mesothelial cells.
  • Asbestos exposure is the primary risk factor, with a long latency period of 30-60 years.
  • Clinical presentation is often nonspecific, necessitating accurate pathological diagnosis.

Purpose of the Study:

  • To summarize the current understanding of malignant pleural mesothelioma (MPM).
  • To highlight diagnostic methods and histological classifications.
  • To discuss treatment approaches, emphasizing the shift in surgical philosophies.

Main Methods:

  • Diagnosis relies on adequate tissue specimens, with video-assisted thoracoscopic surgery (VATS) offering the highest diagnostic yield.
  • Histological classification includes epithelioid, sarcomatoid, and biphasic subtypes.
  • Staging involves invasive tests to guide interdisciplinary treatment planning.

Main Results:

  • Multi-modal treatment (surgery, radiation oncology, chemotherapy) is superior for eligible patients.
  • The primary goal of surgical therapy is macroscopic complete resection.
  • A paradigm shift has occurred from extrapleural pneumonectomy (EPP) to radical pleurectomy (RP) as the preferred surgical option.

Conclusions:

  • Accurate diagnosis and staging are crucial for optimal multi-modal treatment of MPM.
  • Radical pleurectomy (RP) is increasingly favored over extrapleural pneumonectomy (EPP) in surgical management.
  • Understanding MPM subtypes and treatment options is vital for patient outcomes.

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