Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 May;6 Suppl 2(Suppl 2):S238-52.
doi: 10.3978/j.issn.2072-1439.2014.05.03.

Management of malignant pleural mesothelioma-The European experience

Isabelle Opitz  1
Affiliations
Review

Management of malignant pleural mesothelioma-The European experience

Isabelle Opitz. J Thorac Dis. 2014 May.

Abstract

Management of malignant pleural mesothelioma (MPM) remains a clinical challenge and the incidence of the disease will continue to increase worldwide. Several aspects of mesothelioma treatment are discussed controversially, in particular, regarding extent and best type of surgery, radiotherapy, and the role of neoadjuvant or adjuvant treatment. However, best survival data is reported from groups using multimodality treatment including macroscopic complete resection (MCR) achieved by either extrapleural pneumonectomy (EPP) or (extended) pleurectomy/decortication for patients qualifying from the tumor biology, stage, and patient's performance status and comorbidities. Several aspects have to be considered during surgery but morbidity and mortality have been reduced at experienced centres. The final analysis of extended selection algorithms is pending.

Keywords: Mesothelioma; multimodal treatment; pneumonectomy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Normal and diseased pleura.
Figure 2
Figure 2
Measurement of tumor volume of mesothelioma on the left side in green. A total volume of 205 cm3 was evaluated with the help of dedicated software, Myrian, Intrasense, France. The program allows semiautomated differentiation between tumor tissue and effusion. (Courtesy of Dr. Thi Dan Linh Nguyen-Kim and Dr. Thomas Frauenfelder).
Figure 3
Figure 3
Summary of median overall survival outcomes for patients with malignant pleural mesothelioma who underwent extended pleurectomy/decortication (eP/D) or extrapleural pneumonectomy (EPP). Circle radius is logistically proportional to the size of individual studies. Solid lines indicate survival measured from the date of diagnosis, and dotted lines indicate survival measured from the date of surgery. From Cao et al. 2014 (59).
Figure 4
Figure 4
CT scan before and after induction chemotherapy showing a partial remission according to RECIST criteria.
Figure 5
Figure 5
EORTC 1205 randomized phase II study of pleurectomy/decortication preceded or followed by (neo)-adjuvant chemotherapy in patients with early stage malignant pleural mesothelioma.
See this image and copyright information in PMC

References

    1. Park EK, Takahashi K, Hoshuyama T, et al. Global magnitude of reported and unreported mesothelioma. Environ Health Perspect 2011;119:514-8 - PMC - PubMed
    1. Lianes P, Remon J, Bover I, et al. SEOM guidelines for the treatment of malignant pleural mesothelioma. Clin Transl Oncol 2011;13:569-73 - PubMed
    1. Stahel RA, Weder W, Lievens Y, et al. Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010;21Suppl 5:v126-8 - PubMed
    1. Wagner JC, Sleggs CA, Marchand P. Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province. Br J Ind Med 1960;17:260-71 - PMC - PubMed
    1. Marinaccio A, Binazzi A, Cauzillo G, et al. Analysis of latency time and its determinants in asbestos related malignant mesothelioma cases of the Italian register. Eur J Cancer 2007;43:2722-8 - PubMed