Adoption of pleurectomy and decortication for malignant mesothelioma leads to similar survival as extrapleural pneumonectomy

Abstract

Adoption of PD as the main surgical approach is not associated with survival disadvantage in the surgical treatment of MPM.

Pleurectomy/decortication versus extrapleural pneumonectomy: a critical choice

“…Grades 3-4 pneumonitis have been reported in up to 20% of patients (24). Nevertheless, extended P/D, especially when a trimodality scheme is scheduled, is associated with a better short-term outcome, compared to EPP (27,28). Intra-postoperative P/D most common complications are: bleeding (sometimes more profuse than in EPP), postoperative persistent air leaks [caused by the visceral pleura resection ( Figure 1B)] and mucous plugging with possible atelectasis.…”

Is Pleurectomy/Decortication Superior to Extrapleural Pneumonectomy for Patients with Malignant Pleural Mesothelioma? A Single-Institutional Experience

“…In one meta-analysis, the short-term mortality rate (perioperatively and within 30 days) was 4.5% in EPP and 1.7% in P/D. 9) In other studies, the median survival durations of patients who [6][7][8]11) which are not satisfactory results in large-scale studies. Additionally, no consensus regarding which procedure is superior to the other has yet been reached.…”

“…Many reports [6][7][8] have compared the outcomes of P/D and EPP in terms of morbidity, mortality, and survival, suggesting that P/D is comparable with EPP in terms of various surgical outcomes. Taioli et al 9) recommend P/D because of its 2.5-fold lower short-term mortality.…”

Surgery for malignant pleural mesothelioma: an international guidelines review

“…Initially P/D was considered only palliative, but during the decades its role was redefined and this type of surgery gained an important position as a radical surgery. Recent studies have shown that survival time after EPP and P/D is similar, while mortality and morbidity are higher post EPP (24,40,41).…”