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(Chest. 2003;123:551-561.)
© 2003 American College of Chest Physicians

Surgical Treatment of Malignant Pleural Mesothelioma*

A Review

Serge van Ruth, MD; Paul Baas, MD, PhD, FCCP and Frans A. N. Zoetmulder, MD, PhD

* From the Department of Surgical Oncology (Drs. van Ruth and Zoetmulder) and Thoracic Oncology (Dr. Baas), The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.

Correspondence to: Serge van Ruth, MD, Department of Surgical Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands; e-mail: s.v.ruth{at}nki.nl

Despite many years of clinical research, there is still no effective therapy for malignant pleural mesothelioma (MPM). Untreated, the prognosis is poor, with a median survival of < 1 year. Single-agent or combination chemotherapy as well as radiotherapy have not shown persistent improvements in response or survival. In general, MPM is a disease confined to the pleural cavity for a long time before metastasizing. Therefore, focus on local treatment seems rational. Surgical resection has been considered the mainstay of treatment by some. However, surgery alone results in high recurrence rates, and the survival benefit remains questionable. In recent years, the emphasis has been on surgery combined with adjuvant therapies. In this article, the present state of surgical management of MPM will be reviewed.

Key Words: adjuvant therapy • mesothelioma • pleural cavity • review • surgery




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