Malignant Pleural Mesothelioma: Present Status and Future Directions

Malignant pleural mesothelioma is a life-threatening neoplasm of the mesothelium, the layer of tissue that covers many organs in the human body. The incidence of this type of neoplasm is gradually ...
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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.