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Extended Pleurectomy and Decortication for Malignant Pleural Mesothelioma
1Department of Surgery, Division of General Thoracic Surgery, The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
Thoracic Surgery Clinics
|October 5, 2020
Summary
Extended pleurectomy and decortication (ePD) is a preferred surgical option for malignant pleural mesothelioma, offering lung preservation. International efforts are standardizing this complex procedure to improve patient outcomes and safety.
Area of Science:
- Thoracic surgery
- Surgical oncology
- Malignant pleural mesothelioma treatment
Background:
- Malignant pleural mesothelioma requires surgical resection.
- Extended pleurectomy and decortication (ePD) is a complex thoracic surgical procedure.
- ePD allows for macroscopic complete resection while preserving lung function.
Purpose of the Study:
- To highlight the growing preference for ePD over extrapleural pneumonectomy for malignant pleural mesothelioma.
- To emphasize the benefits of ePD, including lower mortality and better tolerance in specific patient groups.
- To report on international efforts to establish surgical guidelines for ePD.
Main Methods:
- Review of surgical outcomes and patient tolerance for ePD.
- Comparison of ePD with extrapleural pneumonectomy.
- Initiation of international collaborative data collection for guideline development.
Main Results:
- ePD demonstrates lower perioperative mortality compared to alternative procedures.
- ePD offers similar long-term survival rates.
- Patients with lower performance status tolerate ePD better.
Conclusions:
- ePD is increasingly favored for malignant pleural mesothelioma resection due to its favorable risk-benefit profile.
- Standardization and guideline development are crucial for enhancing the safety and consistency of ePD.
- International collaboration is key to advancing the surgical management of this disease.
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