A Japanese research group have described a new surgical technique that they suggest may improve survival in mesothelioma patients, by addressing a problem with current procedure[i].
In the surgical procedure known as pleurectomy-decortication (P/D), the pleural lung lining and all visible tumour masses are removed, while leaving the lung itself in place. This is often referred to as lung-sparing surgery, and is the preferred approach in many cases where mesothelioma has not spread to the lung tissue[ii]. Most studies have found that P/D has a lower complication rate, produces less pain, and allows for faster recovery than surgery in which the lung itself is removed.
At the start of the P/D procedure, a sharp incision into the pleura and the tumour is made. This may cause the spread of tumour cells into other areas, which could lead to the development of new tumours. This means that the surgical procedure itself can cause new mesothelioma tumours to grow, shortening the length of time the patient will survive.
The researchers describe a new procedure that does not involve cutting into the pleura, referred to as ‘non-incisional P/D’. The surgeon removes the entire pleura and tumour at once, which the team believes may improve survival.
This is one of many new treatment options being pursued for malignant mesothelioma, which is almost always a result of exposure to asbestos.
[i] Tanaka, F., Imanishi, N., Takenaka, M. & Taira, A. Non-incisional pleurectomy–decortication for malignant pleural mesothelioma. Surg Today 1–3 (2018). doi:10.1007/s00595-018-1624-0 https://link.springer.com/article/10.1007/s00595-018-1624-0 (Accessed 15 March 2018)
[ii] New Surgical Technique May Improve Mesothelioma Survival. Surviving Mesothelioma. 4 March 2018 https://survivingmesothelioma.com/new-surgical-technique-may-improve-mesothelioma-survival/ (Accessed 14 March 2018)