This may represent an important paradigm shift in the surgical management of malignant pleural mesothelioma.
Raleigh, NC (PRWEB) December 26, 2013
While debate continues among mesothelioma doctors worldwide over which kind of surgery is best, a new review of the medical literature published in Lung Cancer and detailed by Surviving Mesothelioma says the statistics are clearly on the side of the lung-sparing procedure called extended P/D.
The report reviewed six electronic databases of medical studies and found seven relevant studies comparing lung-sparing extended P/D with lung-removing extrapleural pneumonectomy (EPP) for malignant pleural mesothelioma. According to the study, the mortality rate with EPP is 6.9% while only 2.9% of studied patients die from extended P/D.
The rate of complications with P/D is also lower, according to the study. Only 27.9% of P/D patients experienced serious complications, compared to more than 60% with EPP. Proponents of EPP, including some of the world’s top mesothelioma doctors, often point to studies showing a survival benefit with EPP. But the new analysis refutes that idea, as well, finding a median overall survival among all the studies of 13-29 months with P/D versus 12-22 months with EPP.
Extended P/D, the most radical form of P/D, removes the pleural lining and other diseased tissue, but leaves the lung in place. In contrast, EPP involves removal of the entire pleural lining as well as the diseased lung, the lymph nodes, portions of the pericardium around the heart and all or part of the diaphragm. It is typically followed by chemotherapy and/or radiotherapy to kill any residual mesothelioma cells.
The results of the literature review are likely to reheat the surgery debate among mesothelioma doctors and the authors say they may well change the way the disease is treated. “This may represent an important paradigm shift in the surgical management of malignant pleural mesothelioma,” they write. Their article appears in Lung Cancer. (Cao, C, et al, “A systematic review and meta-analysis of surgical treatments for malignant pleural mesothelioma”, December 6, 2013, Lung Cancer, Epub ahead of print, http://www.ncbi.nlm.nih.gov/pubmed/24360321)
For nearly ten years, Surviving Mesothelioma has brought readers the most important and ground-breaking news on the causes, diagnosis and treatment of mesothelioma. All Surviving Mesothelioma news is gathered and reported directly from the peer-reviewed medical literature. Written for patients and their loved ones, Surviving Mesothelioma news helps families make more informed decisions.