Mesothelioma
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Current surgical management of malignant
pleural mesothelioma
SOURCE: Curr Oncol Rep 2002 Jul;4(4):354-60
Zellos L, Sugarbaker DJ.
Division of Thoracic Surgery, Brigham and Women's Hospital, Harvard Medical
School, 75 Francis Street, Boston, MA 02115, USA.
Malignant pleural mesothelioma is a rare and very aggressive malignancy
with an increasing incidence. Single-modality therapy has failed to improve
median survival. Current surgical therapies include palliative and cytoreductive
procedures. The rarity of the disease, the lack of randomized surgical
studies, and the lack of a universally accepted and validated staging
system make it difficult to reach consensus and establish stage-specific
protocols. However, with strict criteria, subsets of patients can be identified
who can benefit from aggressive cytoreductive surgical approaches, such
as extrapleural pneumonectomy, and adjuvant chemoradiation protocols.
Our experience with this type of protocol in carefully selected patients
has resulted in increased median survival. The lack of cure in any of
the published protocols demonstrates the need for new therapies and approaches
for this disease.
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