2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.14A.19 Pleurectomy Decortication for Malignant Pleural Mesothelioma: Safe and Faster Technique

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The study by Masaya Yotsukura and colleagues from the National Cancer Center Hospital in Japan compares two surgical treatments for malignant pleural mesothelioma (MPM): pleurectomy/decortication (P/D) and extrapleural pneumonectomy (EPP). The researchers aimed to evaluate the safety, efficiency, and postoperative outcomes of P/D against the more traditional EPP method.<br /><br />Data from 79 patients treated between 1999 and 2022 were analyzed, comparing perioperative outcomes, complications, and overall survival. The results indicated that P/D is a safer and faster alternative to EPP. Key findings include a significantly shorter median operation duration for P/D (231 minutes) compared to EPP (350 minutes), and a notable decrease in severe postoperative complications (5.3% for P/D vs. 31.7% for EPP).<br /><br />Despite these differences, both techniques yielded comparable postoperative oncological prognoses based on Kaplan-Meier survival analysis, indicating no significant difference in overall survival (P=0.938). The faster operation of P/D is attributed to the elimination of complex dissections required in EPP, which involve pulmonary vessels and bronchial processing. Additionally, the multitasking potential of P/D facilitates simultaneous surgical procedures by multiple surgeons, reducing operation time.<br /><br />The study concludes that the standardized P/D method is preferable due to its safety, reduced invasiveness, and comparable efficacy to EPP. The authors recommend P/D over EPP for treating MPM, emphasizing its efficiency in reducing surgical morbidity, mortality, and operation-related complications such as atelectasis and pneumonia. This procedure's potential to minimize operative time and improve patient outcomes makes it a viable option in surgical oncology for MPM.

Asset Subtitle

Masaya Yotsukura

Meta Tag

Speaker Masaya Yotsukura

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

malignant pleural mesothelioma

pleurectomy/decortication

extrapleural pneumonectomy

surgical treatment

perioperative outcomes

postoperative complications

Kaplan-Meier survival analysis

surgical oncology

operation duration

patient outcomes