Which of the following describes a surgical management option for mesothelioma?

Which of the following describes a surgical management option for mesothelioma?

• A. Radical extrapleural pneumonectomy or parietal pleurectomy and decortication with chemotherapy (neoadjuvant/adjuvant depending on staging); If non-operative, definitive chemo
• B. Lobectomy
• C. Radiation therapy alone
• D. Observation

Answer: (A)

Malignant pleural mesothelioma is usually treated with a multimodal approach because the cancer commonly involves the pleural surfaces diffusely. The surgical options aim to remove as much tumor as possible while preserving function when feasible. Radical extrapleural pneumonectomy removes the lung on the involved side along with the pleura, pericardium, and part of the diaphragm, offering a chance for more extensive disease control. Alternatively, parietal pleurectomy with decortication removes the lining and tumor from the chest wall and pleura while sparing the lung, which can be better tolerated in some patients. Either approach is most effective when paired with chemotherapy, given either before surgery to shrink the tumor (neoadjuvant) or after surgery to eradicate residual microscopic disease (adjuvant), with the exact plan guided by stage and patient fitness. If surgery isn’t an option, definitive chemotherapy remains a standard route for disease control. This combination of surgical debulking or resection with systemic therapy reflects the established multimodal strategy for mesothelioma.

Malignant pleural mesothelioma is usually treated with a multimodal approach because the cancer commonly involves the pleural surfaces diffusely. The surgical options aim to remove as much tumor as possible while preserving function when feasible. Radical extrapleural pneumonectomy removes the lung on the involved side along with the pleura, pericardium, and part of the diaphragm, offering a chance for more extensive disease control. Alternatively, parietal pleurectomy with decortication removes the lining and tumor from the chest wall and pleura while sparing the lung, which can be better tolerated in some patients. Either approach is most effective when paired with chemotherapy, given either before surgery to shrink the tumor (neoadjuvant) or after surgery to eradicate residual microscopic disease (adjuvant), with the exact plan guided by stage and patient fitness. If surgery isn’t an option, definitive chemotherapy remains a standard route for disease control. This combination of surgical debulking or resection with systemic therapy reflects the established multimodal strategy for mesothelioma.