Extended pleurectomy/decortication & radical mesothelioma surgery
Pleurectomy and decortication are operations that strip the tumour-bearing lining from the lung and chest wall. They were long assumed to help; the MARS 2 trial showed they do not.
Extrapleural pneumonectomy (removing lung, pleura, diaphragm, pericardium) was largely abandoned after MARS 1 (2011) showed high mortality without benefit. Lung-sparing extended pleurectomy/decortication remained standard in selected centres until MARS 2 (2024) showed worse survival and quality of life with surgery plus chemotherapy than chemotherapy alone. Surgery now has a limited role: diagnosis, palliation (pleurodesis, indwelling catheters), and trials.
How it works
Macroscopic complete resection of parietal and visceral pleura with or without lung; usually within multimodality therapy.
- Symptom relief in trapped lung
- Tissue for diagnosis and research
- No survival benefit in randomised trials
- Significant morbidity and quality-of-life cost
Latest papers
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Pages like this
not linked directly; found by shared links- TermPneumonectomy
Shares MARS 2, Mesothelioma.
- TermPleura
Shares MARS 2, Mesothelioma.
- InstitutionThe Royal Marsden
Shares Mesothelioma, Surgery and radiotherapy cure most, get least.