Pleural mesothelioma is a rare and aggressive cancer. The cancer with a poor prognosis is mainly caused by asbestos. Surgery is an important part of treating pleural mesothelioma, but the impact of surgery on patients’ survival is unclear and sparking debate. A recent study was presented at the World Conference on Lung Cancer. It looked at the survival of pleural mesothelioma. Some patients skipped surgery while others had chemotherapy following surgery. The main goal of the study was to see if surgery could help mesothelioma patients live longer.
There are a variety of surgical treatments and procedures for pleural mesothelioma. A recent study that occurred from January 2011 to December 2021 included 296 patients. All patients were eligible for surgery after three cycles of chemotherapy with platinum plus pemetrexed. Of the 296 patients, 272 had the surgery while 24 refused. Those who underwent surgery had different procedures done. These included pleurectomy/decortication, extrapleural pneumonectomy, and exploratory thoracotomy. The patients who refused surgery were medically fit but chose not to proceed. There were significantly better survival rates in the surgery group compared to the non-surgery group. The surgery group had a median survival of 40.7 months, compared to 23.6 months for the non-surgery group. The median survival without progression was 20.2 months for the surgery group versus 12.9 months for the non-surgery group. The differences were statistically significant, suggesting surgery improves survival for mesothelioma patients.
The study showcases the importance of surgery for mesothelioma. Surgery aims to remove as much cancer as possible and can be combined with other treatments for the best available outcomes. Doctors often perform cytoreductive surgery in combination with other mesothelioma treatments such as chemotherapy. One example is a HIPEC procedure, where surgeons introduce heated chemotherapy directly to the surgical cavity. In peer reviewed medical literature, HIPEC procedures used in peritoneal mesothelioma management report better survival statistics when compared with other surgeries. Immune checkpoint inhibitors also show promise when treating pleural mesothelioma. Early cases rely more on surgery, chemotherapy, and radiotherapy. Past studies suggest surgery alongside chemotherapy can extend mesothelioma patients’ lives. The latest research shows surgery can improve survival in pleural mesothelioma patients. More research is needed to support these findings, but this study adds to growing bodies of evidence supporting the role of surgery in the multimodal treatment of pleural mesothelioma.
