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Published on: December 21, 2019
The Role of Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma
Laura L Donahoe1, Marc de Perrot2
1Division of Thoracic Surgery, Toronto General Hospital, Princess Margaret Cancer Center, University Health Network, Toronto, Canada.
Abstract:
Extrapleural pneumonectomy (EPP) is the most extensive form of surgery for mesothelioma, involving en bloc resection of visceral and parietal pleura, lung, diaphragm and pericardium, with reconstruction of the pericardium and diaphragm. It can be performed safely in carefully selected patients. It should be performed in experienced centers as part of a multimodality treatment plan. The SMART approach, with a short course of induction hemithoracic radiation followed by EPP has demonstrated safety and value of hypofractionated hemithoracic radiation combined with complete macroscopic resection. We are conducting a clinical trial with oligofractionated hemithoracic radiation in early-stage mesothelioma.
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