A Guide to Mesothelioma
 | About MeThis guide is to describe the effects of the lung cancer known as mesothelioma. |
Study Says Lung Function “Significantly Reduced” by Radical Surgery
As the debate continues over which type of mesothelioma surgery is best, a new study suggests that the less radical approach may result in a better quality of life for patients.
Researchers from Freiburg, Germany say mesothelioma patients in their study could breathe better after pleurectomy/decortication (P/D) surgery than they could after have extrapleural pneumonectomy (EPP), resulting in less shortness of breath and a higher quality of life. During P/D, the surgeon removes only the diseased pleura (lung lining) and the remaining cancer is treated aggressively with other types of therapies. In contrast, EPP surgery involves the removal of not only the diseased pleura, but also the closest lung, the lymph nodes, portions of the pericardium (lining around the heart), and all or part of the diaphragm.
For their new study, the researchers compared the cases of 25 mesothelioma patients who had undergone EPP with 23 mesothelioma patients who had undergone P/D instead. All were treated at the University Medical Center in Freiburg. The patients’ medical histories, histological subtypes, overall survival and lung function before and after surgery were evaluated. After analyzing all the data, the researchers concluded that P/D did not have the negative effect on lung function that EPP had.
“In the extrapleural pleuropneumonectomy group, the median preoperative total lung capacity of 4.8 L (77.7%) differed significantly from the postoperative total lung capacity of 3.5 L (55.3%; p <0.0006),” write the authors. “The median vital capacity was significantly reduced from 2.8 L (77.7%) preoperatively to 1.8 L (47.6%) postoperatively (p <0.0002).” Vital capacity is a measure of the amount of air a patient can exhale after a breath. Healthy patients typically have a vital capacity between 3 and 5 L. The team further reports that “other parameters” were also highly significantly reduced after EPP.
Despite the findings, choosing a surgical option remains a highly personal decision between a mesothelioma patient and his or her physician. Other studies have suggested that many factors can influence surgical outcome, including a patient’s age, gender, cancer stage, and co-existing health conditions. The new study appears in the Asian Cardiovascular and Thoracic Annals.
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