There is a debate about whether surgery for mesothelioma is beneficial. A new study was presented at the World Conference on Lung Cancer. The study looked at the survival of pleural mesothelioma patients who had different types of treatment. These included chemotherapy followed by surgery and chemotherapy only. The goal of the study was to see if surgery could help patients live longer.
There are multiple different surgical treatments and other treatments for pleural mesothelioma. The most recent study, which occurred from January 2011 through December 2021, involved 296 patients. All the patients were eligible for surgery after three cycles of platinum plus pemetrexed chemotherapy. Of the patients who were eligible, 24 refused the surgery. Patients who received surgery either had pleurectomy/decortication, extrapleural pneumonectomy, or exploratory thoracotomy. The patients that refused the surgery were medically able to receive it but chose not to move forward. The study saw better outcomes in the surgery group. The median overall survival was 40.7 months compared to 23.6 months for the non-surgery group. The surgery group also had a better progression free survival. The progression free survival was 20.2 months for the surgery group compared to 12.9 months for the non-surgery group. The differences in survival were considered statistically significant, meaning surgery likely improves the survival in mesothelioma patients.
This study showcases the importance of surgery as a treatment for mesothelioma. Surgery removes as much cancer as possible while also being able to be combined with other treatments. Cytoreductive surgery is usually performed alongside chemotherapy. One treatment, HIPEC (heated intraperitoneal chemotherapy), involved surgeons introducing heated chemotherapy into the surgical cavity. The study reported that there were superior survival times with this procedure compared to other procedures.
Another promising approach to treating mesothelioma is the use of immune checkpoint inhibitors. Most cases when caught early though usually use a combination of surgery, chemotherapy, and radiotherapy. Past studies show that there is potential in chemotherapy and surgery for extending survival in mesothelioma patients. More research is needed to show the effectiveness of surgery as part of a multimodal treatment approach for mesothelioma.
Clinical trials like this are important parts of the cancer treatment process. Without clinical trials, we would not have the treatments we have today, and patients would not be living as long as they are today. More studies still need to be done to improve the survival of mesothelioma patients. If more clinical trials are done, we could potentially find a cure or at least lengthen the lives of mesothelioma patients.