Clinical Impact of Surgery for Malignant Pleural Mesothelioma
Pp. 491-514 (24)
Tommaso Claudio Mineo and Vincenzo Ambrogi
The prognosis of malignant pleural mesothelioma remains very poor. The
role of the two intentionally-curative surgical procedures, extra-pleural pneumonectomy
and radical pleurectomy/decortication, is widely debated and mainly focused on the
impact on survival, which is not significantly improved whatever the operation may be.
On these bases the clinical impact of these procedures may assume a relevant
importance on immunology, symptoms and quality of life.
Despite the unsatisfactory results on survival these two procedures proved effective in
ameliorating symptoms and quality of life. In the early-postoperative period, greater
improvements are detected after pleurectomy/decortication, whereas extrapleural
pneumonectomy produced better symptom-relief later. Conversely this procedure may
have a negative impact on immunological conditions thus producing a significantly
greater risk of postoperative infection implying a higher morbidity rate.
Extrapleural pneumonectomy, immunology,
pleurectomy/decortication, quality of life, thoracic surgery.
Division of Thoracic Surgery, Tor Vergata University Policlinic, viale Oxford 81; 00133; Rome, Italy.