Online citations, reference lists, and bibliographies.
← Back to Search

The Role Of Thoracic Surgery In The Management Of Mesothelioma: An Expert Opinion On The Limited Evidence

P. Bertoglio, D. Waller
Published 2016 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
ABSTRACT Surgery has a key role at different points in the management of Malignant Pleural Mesothelioma. Diagnosis with video assisted thoracoscopy offers excellent sensitivity and specificity and a direct view of the pleural cavity to verify the extent of the tumor. Nodal involvement can be assessed by mediastinoscopy and either talc pleurodesis or partial pleurectomy can be used for symptom control in advanced stage disease. Extra Pleural Pneumonectomy (EPP) and Extended Pleurectomy Decortication (EPD) are used to prolong survival although the benefit of radical surgery has not has been fully clarified; EPP failed to show its benefit in the MARS trial and EPD is currently under investigation in the MARS2 trial. More randomized prospective trial data are needed to fully understand the role of radical surgery in the treatment of pleural mesothelioma.
This paper references
10.1097/JTO.0b013e31824de2dc
Prospective Study on Functional Results After Lung-Sparing Radical Pleurectomy in the Management of Malignant Pleural Mesothelioma
S. Boeluekbas (2012)
10.1016/j.athoracsur.2012.02.009
Radical pleurectomy and intraoperative photodynamic therapy for malignant pleural mesothelioma.
J. Friedberg (2012)
10.1016/J.JTCVS.2006.06.044
Impact of lymph node metastasis on outcome after extrapleural pneumonectomy for malignant pleural mesothelioma.
M. D. de Perrot (2007)
10.1016/j.jtcvs.2012.12.037
Hyperthermic intraoperative pleural cisplatin chemotherapy extends interval to recurrence and survival among low-risk patients with malignant pleural mesothelioma undergoing surgical macroscopic complete resection.
D. Sugarbaker (2013)
10.1016/j.athoracsur.2009.09.028
Second surgery for recurrence of malignant pleural mesothelioma after extrapleural pneumonectomy.
L. Politi (2010)
10.6004/JNCCN.2012.0006
[Malignant pleural mesothelioma].
Q. Kong (1983)
10.1007/s11864-014-0314-4
Local and Systemic Therapies for Malignant Pleural Mesothelioma
D. Gomez (2014)
Tumors of the pleura, in Travis WD ,Brambilla E, Muller-Hermelink HK; World Health Organisation Classification of Tumors, Pathology and Genetics of the tumors of the lung, pleura, thymus
A Churg (2004)
10.1136/oemed-2015-103074
Pleural mesothelioma and lung cancer risks in relation to occupational history and asbestos lung burden
C. Gilham (2015)
• One of the largest cohort of patients perspectively collected
10.1016/j.athoracsur.2014.09.056
Meta-analysis of survival after pleurectomy decortication versus extrapleural pneumonectomy in mesothelioma.
E. Taioli (2015)
World Health Organisation classification of tumors, pathology and genetics of the tumors of the lung, pleura, thymus and heart
A Churg (2004)
10.1093/ejcts/ezv403
The effects of an intentional transition from extrapleural pneumonectomy to extended pleurectomy/decortication.
A. Sharkey (2016)
10.1007/s11748-012-0025-3
Localized malignant pleural mesothelioma
Takayuki Nakano (2012)
10.1016/j.athoracsur.2013.03.063
A propensity-matched comparison of pleurodesis or tunneled pleural catheter in patients undergoing diagnostic thoracoscopy for malignancy.
R. Freeman (2013)
10.1016/J.ATHORACSUR.2005.06.014
Extended surgical staging for potentially resectable malignant pleural mesothelioma.
D. Rice (2005)
10.1016/S1470-2045(11)70149-8
Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma: clinical outcomes of the Mesothelioma and Radical Surgery (MARS) randomised feasibility study
T. Treasure (2011)
10.1038/bjc.2013.815
Circulating fibrinogen is a prognostic and predictive biomarker in malignant pleural mesothelioma
B. Ghanim (2014)
10.1016/j.lungcan.2013.04.024
Systematic review of pleurectomy in the treatment of malignant pleural mesothelioma.
C. Cao (2013)
10.1002/14651858.CD002916.PUB2
Pleurodesis for malignant pleural effusions.
P. Shaw (2004)
Lake, Advances in malignant mesothelioma
B. W. Robinson (2005)
10.1016/j.athoracsur.2015.04.087
Prognostic Score of Long-Term Survival After Surgery for Malignant Pleural Mesothelioma: A Multicenter Analysis.
G. Leuzzi (2015)
Tumors of the pleura.
Stout Ap (1952)
10.1097/JTO.0000000000000661
A New Prognostic Score Supporting Treatment Allocation for Multimodality Therapy for Malignant Pleural Mesothelioma: A Review of 12 Years’ Experience
I. Opitz (2015)
10.1245/s10434-007-9508-3
Limited Cardiotoxicity after Extensive Thoracic Surgery and Intraoperative Hyperthermic Intrathoracic Chemotherapy with Doxorubicin and Cisplatin
E. Bree (2007)
10.1016/j.jtcvs.2014.03.011
Malignant pleural mesothelioma and the Society of Thoracic Surgeons Database: an analysis of surgical morbidity and mortality.
B. Burt (2014)
10.1093/ejcts/ezr192
Long-term survival after lung-sparing total pleurectomy for locally advanced (International Mesothelioma Interest Group Stage T3-T4) non-sarcomatoid malignant pleural mesothelioma.
A. Nakas (2012)
Analysis of risk factors and survival from a large international database
10.1016/S0084-3873(11)00245-8
Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010
M. Raza (2011)
Lake, Malignant mesothelioma
B. W. Robinson (2005)
10.1097/JTO.0b013e3182208e3f
Recommendations for Uniform Definitions of Surgical Techniques for Malignant Pleural Mesothelioma: A Consensus Report of the International Association for the Study of Lung Cancer International Staging Committee and the International Mesothelioma Interest Group
D. Rice (2011)
10.1016/j.ijrobp.2014.05.032
Failure patterns after hemithoracic pleural intensity modulated radiation therapy for malignant pleural mesothelioma.
A. Rimner (2014)
10.1016/J.JTCVS.2005.11.044
The pattern of lymph node involvement influences outcome after extrapleural pneumonectomy for malignant mesothelioma.
J. Edwards (2006)
10.1097/JTO.0b013e31820ce2c7
Accuracy of Diagnostic Biopsy for the Histological Subtype of Malignant Pleural Mesothelioma
S. Kao (2011)
10.1183/09031936.00039510
Trimodality therapy for malignant pleural mesothelioma: results from an EORTC phase II multicentre trial
P. V. Van Schil (2010)
10.1016/S0140-6736(03)13079-6
Standard pleural biopsy versus CT-guided cutting-needle biopsy for diagnosis of malignant disease in pleural effusions: a randomised controlled trial
N. Maskell (2003)
10.1002/cncr.23034
Accuracy of pleural biopsy using thoracoscopy for the diagnosis of histologic subtype in patients with malignant pleural mesothelioma
L. Greillier (2007)
10.1016/S1010-7940(01)01130-7
Long-term follow-up of video-assisted talc pleurodesis in malignant recurrent pleural effusions.
G. Cardillo (2002)
10.1016/j.athoracsur.2007.11.065
Risk factors for major complications after extrapleural pneumonectomy for malignant pleural mesothelioma.
M. D. de Perrot (2008)
10.1007/978-3-642-10862-4
[Malignant mesothelioma].
J. Espinosa Arranz (1994)
10.1016/S1470-2045(11)70307-2
The MARS feasibility trial: conclusions not supported by data.
W. Weder (2011)
10.1097/JTO.0b013e31824ab6c5
Pleurectomy/Decortication is Superior to Extrapleural Pneumonectomy in the Multimodality Management of Patients with Malignant Pleural Mesothelioma
L. Lang-Lazdunski (2012)
10.1378/CHEST.107.5.1454
Video-assisted thoracoscopic pleurectomy in the management of malignant pleural effusion.
D. Waller (1995)
Randomized Trials of Systemic Medically-treated Malignant Mesothelioma: A Systematic Review.
C. Blomberg (2015)
10.3978/j.issn.2072-1439.2013.11.28
Guidelines for the diagnosis and treatment of malignant pleural mesothelioma.
N. van Zandwijk (2013)
10.1016/j.jtcvs.2014.10.041
Pleurectomy/decortication, hyperthermic pleural lavage with povidone-iodine, prophylactic radiotherapy, and systemic chemotherapy in patients with malignant pleural mesothelioma: a 10-year experience.
L. Lang-Lazdunski (2015)
10.2169/INTERNALMEDICINE.53.1563
"Dry" pleural mesothelioma successfully diagnosed on endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA).
F. Lococo (2014)
10.1016/S1470-2045(15)00208-9
Neoadjuvant chemotherapy and extrapleural pneumonectomy of malignant pleural mesothelioma with or without hemithoracic radiotherapy (SAKK 17/04): a randomised, international, multicentre phase 2 trial.
R. Stahel (2015)
10.1136/thx.2010.136994
Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010
M. Roberts (2010)
10.1016/J.EJCTS.2007.01.061
Right extrapleural pneumonectomy for malignant mesothelioma via median sternotomy or thoracotomy? Short- and long-term results.
J. Edwards (2007)
10.1016/j.ejcts.2010.02.028
Obtaining an upper estimate of the survival benefit associated with surgery for mesothelioma.
M. Utley (2010)
10.1093/ejcts/ezr251
The new case for cervical mediastinoscopy in selection for radical surgery for malignant pleural mesothelioma.
A. Nakas (2012)
10.1016/J.EJCTS.2006.01.015
Incidence and management of complications after neoadjuvant chemotherapy followed by extrapleural pneumonectomy for malignant pleural mesothelioma.
I. Opitz (2006)
10.1200/JCO.2008.17.5604
Trimodality therapy with induction chemotherapy followed by extrapleural pneumonectomy and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma.
M. D. de Perrot (2009)
[Extrapleural pneumonectomy for malignant pleural mesothelioma].
Yoshio Hosokawa (2004)
Controlled randomized trial comparing surgical techniques in a palliative setting
10.1097/JTO.0b013e31827740f0
Patterns of Failure, Toxicity, and Survival after Extrapleural Pneumonectomy and Hemithoracic Intensity-Modulated Radiation Therapy for Malignant Pleural Mesothelioma
D. Gomez (2013)
10.1016/J.ATHORACSUR.2004.05.007
Pleural biopsy: a reliable method for determining the diagnosis but not subtype in mesothelioma.
R. Bueno (2004)
10.1093/ejcts/ezs648
Factors predicting poor survival after lung-sparing radical pleurectomy of IMIG stage III malignant pleural mesothelioma.
S. Boeluekbas (2013)
10.1016/S0003-4975(99)01038-3
Important prognostic factors in patients with malignant pleural mesothelioma, managed surgically.
V. Rusch (1999)
10.1016/j.lungcan.2013.10.013
Radical pleurectomy/decortication followed by high dose of radiation therapy for malignant pleural mesothelioma. Final results with long-term follow-up.
E. Minatel (2014)
10.1016/j.athoracsur.2014.11.050
Persistent lung expansion after pleural talc poudrage in non-surgically resected malignant pleural mesothelioma.
O. Rena (2015)
10.1258/jrsm.2010.100345
A systematic review of lung-sparing extirpative surgery for pleural mesothelioma
Elaine S Teh (2011)
10.1097/JTO.0b013e3181a8c874
Localized malignant pleural mesothelioma: report of two cases.
Silvia Tanzi (2009)
10.1016/j.jtcvs.2015.10.036
Pleurectomy decortication for mesothelioma: The procedure of choice when possible.
R. Flores (2016)
10.1016/J.EJCTS.2006.11.046
A phase II study of intrapleural immuno-chemotherapy, pleurectomy/decortication, radiotherapy, systemic chemotherapy and long-term sub-cutaneous IL-2 in stage II-III malignant pleural mesothelioma.
M. Lucchi (2007)
10.1002/jso.21261
Symptomatic and quality of life changes after extrapleural pneumonectomy for malignant pleural mesothelioma
V. Ambrogi (2009)
10.1016/j.athoracsur.2015.04.151
Extended Pleurectomy and Decortication for Malignant Pleural Mesothelioma Is an Effective and Safe Cytoreductive Surgery in the Elderly.
T. Williams (2015)
Occupational, domestic and environmentalmesothelioma risks in Britain: a casecontrol study
J Peto (2009)
10.1016/J.EJCTS.2003.12.001
The case for routine cervical mediastinoscopy prior to radical surgery for malignant pleural mesothelioma.
J. Pilling (2004)
10.1016/j.jtcvs.2015.09.129
Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma.
M. D. de Perrot (2016)
10.1016/j.lungcan.2013.04.019
Radical pleurectomy and chemoradiation for malignant pleural mesothelioma: the outcome of incomplete resections.
S. Boeluekbas (2013)
10.3978/j.issn.2072-1439.2014.05.03
Management of malignant pleural mesothelioma-The European experience.
I. Opitz (2014)
10.1016/j.ejcts.2008.03.034
Video-assisted cervical thoracoscopy: a novel approach for diagnosis, staging and pleurodesis of malignant pleural mesothelioma.
M. Chamberlain (2008)
10.1016/S0140-6736(14)60418-9
Efficacy and cost of video-assisted thoracoscopic partial pleurectomy versus talc pleurodesis in patients with malignant pleural mesothelioma (MesoVATS): an open-label, randomised, controlled trial
R. Rintoul (2014)
10.1016/j.ijrobp.2011.09.027
Pleural intensity-modulated radiotherapy for malignant pleural mesothelioma.
K. Rosenzweig (2012)
10.1016/j.jtcvs.2007.10.054
Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: results in 663 patients.
R. Flores (2008)
10.1097/JTO.0000000000000064
Does Surgery Improve Survival of Patients with Malignant Pleural Mesothelioma?: A Multicenter Retrospective Analysis of 1365 Consecutive Patients
P. Bovolato (2014)
10.1183/09031936.00063109
Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma
A. Scherpereel (2009)
Occupational, domestic and environmental mesothelioma risks in Britain
J. Peto (2009)
10.1016/S1556-0864(15)31536-7
Macroscopic complete resection: the goal of primary surgery in multimodality therapy for pleural mesothelioma.
D. Sugarbaker (2006)
10.1510/icvts.2009.213611
Staging algorithm for diffuse malignant pleural mesothelioma.
M. Zieliński (2010)
10.1245/s10434-006-9160-3
Extrapleural Pneumonectomy Is the Preferred Surgical Management in the Multimodality Therapy of Pleural Mesothelioma: Con Argument
R. Cameron (2006)
10.1097/SLA.0000000000000903
Extrapleural Pneumonectomy in the Treatment of Epithelioid Malignant Pleural Mesothelioma: Novel Prognostic Implications of Combined N1 and N2 Nodal Involvement Based on Experience in 529 Patients
D. Sugarbaker (2014)
Long-term survival after lungsparing total pleurectomy for locally advanced (International Mesothelioma Interest Group Stage T3-T4) non-sarcomatoid malignant pleural mesothelioma
A Nakas (2012)
10.1093/ANNONC/MDM093
Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma.
W. Weder (2007)
10.1016/J.EJCTS.2004.12.028
Extra-pleural pneumonectomy for malignant pleural mesothelioma: the risks of induction chemotherapy, right-sided procedures and prolonged operations.
D. Stewart (2005)
10.1016/j.lungcan.2011.12.009
Extrapleural pneumonectomy for early stage malignant pleural mesothelioma: a harmful procedure.
O. Rena (2012)
10.1016/j.jtcvs.2013.01.039
The role of surgical cytoreduction in the treatment of malignant pleural mesothelioma: meeting summary of the International Mesothelioma Interest Group Congress, September 11-14, 2012, Boston, Mass.
V. Rusch (2013)
10.1067/MTC.2001.116560
A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma.
V. Rusch (2001)
10.1016/J.EJCTS.2007.09.039
The role of video assisted thoracoscopic pleurectomy/decortication in the therapeutic management of malignant pleural mesothelioma.
A. Nakas (2008)
10.1097/JTO.0b013e31826915f1
Initial Analysis of the International Association For the Study of Lung Cancer Mesothelioma Database
V. Rusch (2012)
10.1016/J.ATHORACSUR.2007.06.066
Malignant pleural mesothelioma: surgical management in 285 patients.
P. Schipper (2008)
10.1002/14651858.CD002916.pub3
WITHDRAWN: Pleurodesis for malignant pleural effusions.
P. Shaw (2013)
Surgery in mesotheliomado we go after MARS ?
B. I. Hiddinga (2013)
10.1038/sj.bjc.6604879
Occupational, domestic and environmental mesothelioma risks in the British population: a case–control study
C. Rake (2009)
10.1245/s10434-011-1728-x
Summary of Prognostic Factors and Patient Selection for Extrapleural Pneumonectomy in the Treatment of Malignant Pleural Mesothelioma
Mbbs Christopher Cao BSc (2011)
Controlled randomized trial feasibility study comparing chemotherapy and EPP versus chemotherapy alone
[Tumors of the pleura].
J. Kalb (1961)
10.1016/j.cllc.2012.03.011
Validation of prognostic factors in malignant pleural mesothelioma: a retrospective analysis of data from patients seeking compensation from the New South Wales Dust Diseases Board.
S. Kao (2013)
10.1093/ejcts/ezt664
Predictors of long-term survival following radical surgery for malignant pleural mesothelioma.
A. Nakas (2014)
10.1016/j.athoracsur.2009.12.041
Therapeutic surgery for nonepithelioid malignant pleural mesothelioma: is it really worthwhile?
B. Balduyck (2010)
10.1097/JTO.0b013e3181ed0489
A Systematic Review of Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma
C. Cao (2010)
10.1016/j.athoracsur.2009.05.022
Endoscopic ultrasound-guided fine needle aspiration for staging of malignant pleural mesothelioma.
D. Rice (2009)
10.1111/cyt.12263
The role of endobronchial ultrasound‐guided fine needle aspiration in the diagnosis of pleural mesothelioma
M. Ghigna (2016)
10.1016/J.EJCTS.2007.09.043
Localised malignant pleural mesothelioma: a separate clinical entity requiring aggressive local surgery.
A. Nakas (2008)
10.1097/JTO.0b013e31828353d7
Surgery in mesothelioma--where do we go after MARS?
B. Hiddinga (2013)
10.1016/j.athoracsur.2014.01.050
Extrapleural pneumonectomy for malignant mesothelioma: an Italian multicenter retrospective study.
L. Spaggiari (2014)
10.1016/J.EJSO.2004.08.014
Improved survival with VATS pleurectomy-decortication in advanced malignant mesothelioma.
J. Halstead (2005)
10.1093/ejcts/ezt022
Lung-sparing total pleurectomy: the surgical option of choice in malignant pleural mesothelioma?
D. Waller (2013)
10.1016/j.ejcts.2008.07.050
Preoperative staging of mesothelioma by 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography fused imaging and mediastinoscopy compared to pathological findings after extrapleural pneumonectomy.
J. Sørensen (2008)
• Recommendation for definition of different surgical approaches for MPM
10.1056/NEJMRA050152
Advances in malignant mesothelioma.
B. Robinson (2005)
Efficacy and cost of videoassisted thoracoscopic partial pleurectomy versus talc pleurodesis in patients with malignant pleural mesothelioma (MesoVATS): an open-label, randomised, controlled trial
R C Rintoul (2014)
10.1016/j.lungcan.2014.01.021
Surgery for malignant pleural mesothelioma: why, when and what?
L. Lang-Lazdunski (2014)
10.1016/j.lungcan.2013.11.026
A systematic review and meta-analysis of surgical treatments for malignant pleural mesothelioma.
C. Cao (2014)
10.1016/j.athoracsur.2014.12.077
Intrapleural Photodynamic Therapy for Mesothelioma: What Place and Which Future?
C. Munck (2015)
10.1016/j.jtcvs.2013.07.012
Clinical indications and results after chest wall resection for recurrent mesothelioma.
B. Burt (2013)
10.1016/j.lungcan.2009.08.019
Survival after trimodality therapy for malignant pleural mesothelioma: Radical Pleurectomy, chemotherapy with Cisplatin/Pemetrexed and radiotherapy.
S. Boeluekbas (2011)
10.1200/JCO.2008.20.3943
Multicenter phase II trial of neoadjuvant pemetrexed plus cisplatin followed by extrapleural pneumonectomy and radiation for malignant pleural mesothelioma.
L. Krug (2009)



This paper is referenced by
Malignant Pleural Mesothelioma: The Last 8 Years of Experience in Our Area
V. Riveiro (2019)
10.1177/0218492316674861
Chest wall resection for mesothelioma recurrence after surgery
P. Bertoglio (2016)
10.21037/jtd.2017.10.16
Surgery for malignant pleural mesothelioma: an international guidelines review.
S. Ricciardi (2018)
10.1002/14651858.CD012605.pub2
Radical multimodality therapy for malignant pleural mesothelioma.
O. Abdel-Rahman (2018)
10.21037/atm.2017.03.88
A nuanced view of extrapleural pneumonectomy for malignant pleural mesothelioma.
I. Opitz (2017)
10.21037/jxym-20-54
Expectancy survival of malignant pleural effusion patients treated with thoracoscopic pleurodesis related to histology
Elisa Sicolo (2020)
10.1016/j.ijheh.2017.09.013
Estimating past inhalation exposure to asbestos: A tool for risk attribution and disease screening.
J. Cherrie (2018)
10.21037/tlcr.2018.06.07
Extended pleurectomy decortication: the current role.
R. Bilancia (2018)
10.21037/jtd.2017.10.165
The role of intracavitary therapies in the treatment of malignant pleural mesothelioma.
P. Bertoglio (2018)
10.1016/j.jtho.2018.08.001
Surgery in Malignant Pleural Mesothelioma
R. Bueno (2018)
10.2174/1573394713666170907160734
Current and Emerging Therapy for Malignant Pleural Mesothelioma: Focus on CD26/Dipeptidyl Peptidase IV as a Therapeutic Target
B. Doonan (2017)
10.1038/srep46537
Clinical-pharmacogenetic models for personalized cancer treatment: application to malignant mesothelioma
K. Goričar (2017)
10.1016/j.jtcvs.2017.10.070
Diaphragm and lung–preserving surgery with hyperthermic chemotherapy for malignant pleural mesothelioma: A 10‐year experience
M. Ambrogi (2018)
10.1016/j.ejso.2017.02.010
Is less also better? A single-institution experience on treatment of early stage Malignant Pleural Mesothelioma.
P. Bertoglio (2017)
Semantic Scholar Logo Some data provided by SemanticScholar