Elsevier

The Lancet

Volume 384, Issue 9948, 20–26 September 2014, Pages 1080-1081
The Lancet

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Surgical resection of mesothelioma: an evidence-free practice

https://doi.org/10.1016/S0140-6736(14)60795-9Get rights and content

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  • Repurposing therapeutics for malignant pleural mesothelioma (MPM) – Updates on clinical translations and future outlook

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    Unlike antibody therapies, small molecules do not directly affect immune checkpoints, which may render them to be less effective than antibody therapies. Small molecule therapies are usually first-line treatment options with surgical resection or antibody therapies deployed based on the progression of MPM [25,50]. Certain small molecule therapies such as carboplatin/pemetrexed are also being clinically tested as maintenance therapy to improve the progression free survival for patients with unresectable MPM and extend the overall survival for these patients, although with minimal benefits [51].

  • Iron addiction with ferroptosis-resistance in asbestos-induced mesothelial carcinogenesis: Toward the era of mesothelioma prevention

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    However, due to the aggressive nature of the operation, which does not significantly extend the patient's survival, pleural tumorectomy is now recommended, with no intention of complete excision but only for mass reduction [89,90]. Indeed, there is some criticism against any surgical resection [91]. Chemotherapy (anti-folate and cisplatin) and/or radiation can also be used for treatment.

  • Prediction modelling using routine clinical parameters to stratify survival in Malignant Pleural Mesothelioma patients undergoing cytoreductive surgery

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    The role of surgery for MPM is debated, as a small randomized study (MARS) has shown that radical surgery (as part of trimodality therapy) conferred no apparent benefit and there is concern about harm. However, the latest American Society of Clinical Oncology guideline for treatment of MPM recommended that a maximal surgical cytoreduction (hereafter referred to as surgery) should be considered in selected patients with early-stage disease.12-15 Radical surgical treatments for MPM include extrapleural pneumonectomy (EPP: removal of the lung, parietal pleura, pericardium, and part of the diaphragm) or pleurectomy/decortication (P/D: removal of the parietal pleura and tumor bulk from the lung or surrounding tissues).

  • Survival by Histologic Subtype of Malignant Pleural Mesothelioma and the Impact of Surgical Resection on Overall Survival

    2018, Clinical Lung Cancer
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    However, the only known trial randomizing patients to surgical therapy versus its lack showed worse survival and quality of life with surgery.15 Thus, the magnitude of benefit for routine surgery is often, and rightfully, questioned16; however, it has been the subject of spirited debate in the form of better addressing patient selection and possibly more viable alternatives.17-23 For sarcomatoid disease, which is associated with a dismal prognosis, surgery is not recommended, in part owing to most studies' underrepresentation or exclusion of these patients.9-11,15

  • Remember Pleurodesis!

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