Mesothelioma Update

By Mark Block, MD; and Alice M. Boylan, MD

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Surgical Management

The two goals of surgical therapy are palliation of symptoms and resection of tumor with therapeutic intent. Pleurodesis is an effective therapy for the dyspnea caused by recurrent pleural effusions, but is ineffective palliation for the pain caused by invasion of tumor into the chest wall and intercostal nerves. Pleurectomy with decortication (P/D) and extrapleural pneumonectomy (EPP) provide effective palliation of both symptoms and may have therapeutic benefit, but these procedures are major operations that are associated with potentially significant operative morbidity.

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