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Further Research Points to Benefits of P/D Surgery Over EPP for Pleural Mesothelioma Patients

Benefits of PD Surgery Over EPP

Last month, Mesothelioma Help reported that researchers found pleurectomy / decortication (P/D), a surgery to remove mesothelioma tumors, can improve the physical and emotional quality of life for patients. Now, researchers give another reason this option is superior to the other surgical option, extrapleural pneumonectomy (EPP): the possibility of developing pleural sepsis after EPP.

Oncology surgeons must choose between P/D or EPP when deciding to operate on pleural mesothelioma patients. The former spares the lung, whereas the latter is a radical procedure that involves removing the patients diseased lung as well as the possible removal of the diaphragm, the pericardium and other extrapleural tissue.

Researchers from the University Hospital Borgo Trento, Verona, Italy and Humanitas Research Hospital of Milan, looked at 15 years of data, from 2000-2015, of 163 malignant pleural mesothelioma patients who underwent P/D, EPP or palliative pleurectomy surgery for their cancer. The results showed that up to 695 days after surgery, EPP patients had a six-fold higher chance of developing pleural sepsis than the  other patients. In addition, the median overall survival was just 19 months after EPP, compared to 30 months after P/D.

The researchers reported that the patients’ underlying condition and pleural sepsis, but not whether complete resection was achieved, were “significantly associated with survival.”

“Owing to its significant frequency and adverse impact, pleural sepsis may contribute to a reduced life expectancy after EPP,” the researchers concluded.

Mesothelioma patients often face life-threatening complications as they battle the asbestos-caused cancer. According to the Mayo Clinic, sepsis is a “potentially life-threatening complication of an infection.” Sepsis is highly dangerous, and  can lead to organ damage in mesothelioma patients with weakened immune systems. Mesothelioma patients are watched closely for infection throughout their mesothelioma treatments. Approximately 3,000 Americans are diagnosed with mesothelioma each year.

The researchers also report that surgeons and oncologists continue to debate the pros and cons of the two primary surgical options. If you are a mesothelioma patient, discuss your options with your surgeon to determine which surgery may be best for you.

The results of the study can be found in the June 21 issue of  European Journal of Cardiothoracic Surgery.

Photo Credit: Centers for Disease Control and Prevention

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Last Modified: February 26, 2019

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