Clinical Impact of Surgery for Malignant Pleural Mesothelioma

Abstract

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.

Keywords: Extrapleural pneumonectomy, immunology, pleurectomy/decortication, quality of life, thoracic surgery.

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