What is the best approach for surgery of malignant pleural mesothelioma? It is to put our efforts into obtaining trustworthy evidence for practice

Journal of Thoracic Cardiovascular Surgery 2015 September 28 [Epub ahead of print] [Link]

Treasure T.


It is accepted that however radical and expertly done, surgery cannot eradicate mesothelioma and therefore cannot realistically be expected to cure the disease other than in a vanishingly few atypical cases. This is implicit in the adoption of “macroscopic complete resection” as the surgical objective. Because of the nature of the disease and the multiplicity of treatment protocols, defining the direction and magnitude of a survival difference cannot be determined from personal experience, follow-up studies or other methods lacking rigorous control data. Several randomized trials including surgery have been and are being carried out, so “can’t be done” is not a defensible position. Independently run multicenter trials are needed.