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Housman et al. J Cancer Metastasis Treat 2021;7:69 Journal of Cancer
DOI: 10.20517/2394-4722.2021.159
Metastasis and Treatment

Review Open Access

Cancer-directed surgery in malignant pleural
mesothelioma: extrapleural pneumonectomy and

pleurectomy/decortication

Brian Housman, Andrea S. Wolf
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York 10029, USA.
Correspondence to: Andrea S. Wolf, MD, MPH, Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, 1190
Fifth Avenue, Box 1023, New York 10029, USA. E-mail: andrea.wolf@mountsinai.org

How to cite this article: Housman B, Wolf AS. Cancer-directed surgery in malignant pleural mesothelioma: extrapleural
pneumonectomy and pleurectomy/decortication. J Cancer Metastasis Treat 2021;7:69. https://dx.doi.org/10.20517/2394-
4722.2021.159

Received: 5 Aug 2021 First Decision: 15 Sep 2021 Revised: 23 Sep 2021 Accepted: 27 Oct 2021 Published: 13 Dec 2021

Academic Editor: Prasad S. Adusumilli Copy Editor: Yue-Yue Zhang Production Editor: Yue-Yue Zhang

Abstract
Malignant pleural mesothelioma (MPM) is a primary solid malignancy related to inhalational asbestos exposure.
Despite advances in therapy, MPM remains challenging to treat with a post-treatment survival of only 15% at 5-
year. In recent years, extra-pleural pneumonectomy has decreased in popularity due to a high morbidity rate and
mortality compared to pleurectomy/decortication and other therapeutic alternatives. In this review, we will discuss
both procedures, outcomes, ongoing studies, and the roles of surgery in the future treatment of this disease.

Keywords: Surgery for malignant pleural mesothelioma, extrapleural pneumonectomy, pleurectomy/decortication,
recurrence perioperative mortality

INTRODUCTION
Malignant pleural mesothelioma (MPM) is a primary solid malignancy of pleural mesothelial cells related to
[2,3]
[1]
inhalational asbestos exposure . When left untreated, MPM carries a median survival of 6 to 9 months .
Increasing global restrictions in the production and use of asbestos notwithstanding, the incidence of MPM
has increased over the last several decades; the phenomenon is likely due to a lag time of 30-50 years
between exposure and development of the disease .
[3,4]

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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