A Proposed System Toward Standardizing Surgical-Based Treatments for Malignant Pleural Mesothelioma, From the Joint National Cancer Institute–International Association for the Study of Lung Cancer–Mesothelioma Applied Research Foundation Taskforce

Abstract

This article is a joint effort arising from a task force formed at a National Cancer Institute-International Association for the Study of Lung Cancer-Mesothelioma Applied Research Foundation Mesothelioma Clinical Trials Planning Meeting, held at the NIH in March 2017. Malignant pleural mesothelioma remains one of the most virulent and recalcitrant malignancies, still considered incurable, and in desperate need of clinical trials in order to make progress for our patients. Although not standard of care, there is compelling evidence that a select subgroup of mesothelioma patients benefit from a surgery-based multimodal approach. As it is not possible to achieve a microscopically complete resection with mesothelioma, there appears to be no role for surgery alone. Thus, it is anticipated that significant strides in the surgery-based treatment of this cancer will require trials that determine which complementary treatments best augment the cytoreductive efficacy of surgery. Although

Rehabilitation treatment of enteral nutrition whey protein in lung cancer patients in southern China

“…Because lung cancer is a malignant wasting disorder, patients with different degrees of nutritional disorders will develop as the disease progresses (Friedberg et al, 2019;Yuan et al, 2018;Zongwen et al, 2017). At the same time, as the patient's body function decreases with age, the lack of disease recovery capabilities makes it easy to increase malnutrition.…”

Divided by an ocean of water but united in an ocean of uncertainty: A transatlantic review of mesothelioma surgery guidelines

“…There is an ongoing debate about whether all viable tumor equates to all visible tumor, in particular with regard to the management of the visceral pleura. 9 The subplot surrounds a historical North American bias toward EPP over P/D, which many have traditionally considered to be a palliative debulking procedure; however, most North American centres have moved to P/D in the past decade. The only randomized assessment of radical mesothelioma surgery, the MARS trial, 10 originated from the UK; it was a feasibility study to assess the effect of adding EPP to chemotherapy in mediastinoscopy negative cases.…”

Extended pleurectomy and decortication: Video atlas of operative steps

“…To achieve a macroscopic complete resection, either a lung-sparing surgery called an extended pleurectomy/decortication (ePD) or a lung-sacrificing surgery called an extrapleural pneumonectomy is performed. 8 A visceral and parietal pleurectomy includes the “extended” descriptor when resection of the diaphragm and/or pericardium are performed. Whether a partial diaphragm resection should be included as an ePD is questionable, but despite differences in the operations, the goal of an ePD is to remove all visible, palpable, or viable tumor while sparing the lung.…”