Radical surgery for mesothelioma

Cancer/Radiothérapie. 2006 Aug 31; [Epub ahead of print] [Link]

P. Bonnettea

aService de chirurgie thoracique, hôpital Foch, 40, rue Worth, 92151 Suresnes, France

Abstract

Good results obtained by the team from Boston increased the interest in pleuropneumonectomy for mesothelioma. Adjuvant high-dose hemithoracic radiation after surgical resection decreased the local recurrence rate from 35 to 13%. The high rate of peritoneal (26-31%), controlateral pleural and pericardial recurrences justify the routine practice of preoperative laparoscopy and controlateral thoracoscopy and a pleuropneumonectomy without pericardotomy and diaphragmatic resection. The diaphragm is lowered to facilitate radiotherapy. Chemotherapy may be performed postoperatively.