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Extrapleural Pneumonectomy Compared to Pleurectomy Decortication in Treating Mesothelioma
July 8, 2008 — A new study published in The Journal of Thoracic Cardiovascular Surgery, 2008, compares the surgical procedures of extrapleural pneumonectomy (EPP) to pleurectomy decortication for the treatment of malignant pleural mesothelioma in 663 patients in three different institutions. Previous studies have only included small numbers of patients, so scientific opinion on the optimal procedure for resection of malignant pleural mesothelioma remains controversial. Researchers hope the multi–institutional study will increase statistics and help to identify significant differences in outcome between extrapleural pneumonectomy and pleurectomy decortication.
Study Results of the Surgical Management of Malignant Pleural Mesothelioma
Researchers followed 663 mesothelioma patients (538 men and 125 women) who underwent resection between 1990 to 2006. The patient’s average age was 63 years old, with an age range between 26–93 years old. For those who underwent extrapleural pneumonectomy the operative mortality surgery was 7%, meaning 27 out of 385 patients died within 30 days of surgery. For those that underwent pleurectomy/decortication, the operative mortality surgery was 4%, 13 out 278 patients died after surgery.
Significant survival differences were seen depending on the stage of cancer, 1–4 epithelioid versus non–epithelioid histology, extrapleural pneumonectomy versus pleurectomy/decortication, multimodality therapy (combinations of surgery, chemotherapy and radiation therapy) versus surgery alone, and gender. Statistical variables in the study included a hazard rate of 1.4 for extrapleural pneumonectomy controlling for stage, histology, gender, and multimodality therapy. (J Thorac Cardiovasc Surg, 2008;135:620-626)
Mesothelioma, A Rare and Aggressive Asbestos–Related Cancer
Mesothelioma is a rare and aggressive cancer caused by exposure to asbestos. The most common type of mesothelioma is malignant pleural mesothelioma, which is frequently associated with a history of chronic asbestos exposure. The disease affects the pleura, the membrane which lines the chest cavity. Sadly, if untreated the prognosis of a mesothelioma victim is poor, with a median survival rate of less than a year. Some pleural mesothelioma patients decide that radical surgery (a resectomy) is the best option, in order to prolong or improve their quality of life. The two types of surgery are either extrapleural pneumonectomy (EPP) or pleurectomy/decortication.
What are Extrapleural Pneumonectomy and Pleurectomy Decortication?
Extrapleural pneumonectomy (EPP) involves the removal of the entire lung along with its coverings and the associated coverings of the heart and diaphragm, and is performed to remove all visible evidence of tumor. As a result of the operation, a higher amount of radiation can be delivered once the lung is removed. Pleurectomy/decortication involves the removal of the pleura, the lining around the lung, without removing the entire lung. (For more information, please read our article Mesothelioma Treatment: Surgery and Fluid Removal.)
Your Mesothelioma Case, How Brayton Purcell Can Help
For over 24 years, the California–based mesothelioma attorneys of Brayton Purcell have been extensively involved with the legal rights of mesothelioma victims, including injured workers and their families. We have represented both asbestos workers and individuals who have come into contact with asbestos through others. We seek damages to the full extent allowed by law in order to compensate our clients for their pain and suffering, loss of wages, and medical expenses.
If you would like to request more information about how our lawyers can help you, you may contact our mesothelioma attorneys through this web site or at our offices. Although our main offices are in California, Oregon, and Utah, we have a nationwide client base, and many of our mesothelioma lawyers are admitted in multiple states.
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