Initial management of malignant pleural mesothelioma
- Harvey I Pass, MD
Harvey I Pass, MD
- Stephen E. Banner Professor of Thoracic Oncology
- NYU Langone Medical Center
- Anne S Tsao, MD
Anne S Tsao, MD
- Associate Professor
- The University of Texas MD Anderson Cancer Center
- Kenneth Rosenzweig, MD
Kenneth Rosenzweig, MD
- Professor and Chairman
- Department of Radiation Oncology
- Icahn School of Medicine at Mount Sinai
- Section Editors
- Rogerio C Lilenbaum, MD, FACP
Rogerio C Lilenbaum, MD, FACP
- Section Editor — Lung Cancer
- Yale Cancer Center
- Joseph S Friedberg, MD
Joseph S Friedberg, MD
- Section Editor — Thoracic Surgery
- Charles Reid Edwards Professor of Surgery
- University of Maryland
- James R Jett, MD
James R Jett, MD
- Section Editor — Lung Cancer
- Professor of Medicine Emeritus
- National Jewish Health
- Steven E Schild, MD
Steven E Schild, MD
- Section Editor — Radiation Therapy
- Professor of Radiation Oncology
- Mayo Clinic College of Medicine
Malignant pleural mesothelioma (MPM) is a rare neoplasm that typically arises from the mesothelial surfaces of the pleural cavity. Mesotheliomas may also arise from the peritoneal surface, the tunica vaginalis, or pericardium.
MPM has a poor prognosis. The median survival of patients is between 6 and 18 months, and the outlook has not been substantially improved by newer therapeutic interventions. However, carefully selected patients with localized disease who receive aggressive multimodality therapy have relatively prolonged survival.
Data supporting current treatment recommendations are derived from observational studies. The benefits of incorporating surgery and radiation therapy (RT) into the initial treatment have not been demonstrated in randomized trials.
The initial management of patients with MPM is reviewed here. Other related topics include:
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- INITIAL EVALUATION AND CLINICAL APPROACH
- Diagnosis and staging
- Clinical approach
- SURGERY-BASED THERAPY
- Patient selection
- Surgical procedure nomenclature
- - Extrapleural pneumonectomy (EPP)
- - Pleurectomy/decortication (P/D)
- - EPP versus P/D
- Radiation therapy
- - RT after EPP
- - RT after P/D
- Randomized trials
- NONSURGICAL APPROACHES
- Pleural effusions
- Tumor seeding at the operative site
- Radiation therapy
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS