A Decade of Progress: Evolving Surgical Strategies for the Treatment of Pleural Mesothelioma

Opitz I, Bille A, Dafni U, et al. European Epidemiology of Pleural Mesothelioma. J Thorac Oncol. 2023;18(9):1233–47. https://doi.org/10.1016/j.jtho.2023.06.011.

Article  PubMed  Google Scholar 

Sugarbaker DJ, Wolf AS. Surgery for malignant pleural mesothelioma. Expert Rev Respir Med. 2010;4(3):363–72. https://doi.org/10.1586/ers.10.35.

Article  PubMed  Google Scholar 

Flores RM, Pass HI, Seshan VE, et al. Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: results in 663 patients. J Thorac Cardiovasc Surg. 2008;135(3):620–6.

Article  PubMed  Google Scholar 

Bueno R, Opitz I. Surgery in malignant pleural mesothelioma. J Thorac Oncol. 2018;13(11):1638–54. https://doi.org/10.1016/j.jtho.2018.08.001.

Article  PubMed  Google Scholar 

Waller DA, Tenconi S. Surgery as part of radical treatment for malignant pleural mesothelioma. Curr Opin Pulm Med. 2017;23(4):334–8.

Article  PubMed  Google Scholar 

Larose F, Quigley N, Lacasse Y, Martel S, Lang-Lazdunski L. Malignant pleural mesothelioma: comparison of surgery-based trimodality therapy to medical therapy. Lung Cancer. 2021;156:151–6.

Article  CAS  PubMed  Google Scholar 

Ichiki Y, Goto H, Fukuyama T, Nakanishi K. Should Lung-Sparing Surgery Be the Standard Procedure for Malignant Pleural Mesothelioma? J Clin Med. 2020;9(7):2153.

Article  PubMed  PubMed Central  Google Scholar 

Woodard GA, Jablons DM. Surgery for pleural mesothelioma, when it is indicated and why: arguments against surgery. Translational Lung Cancer Res. 2020;9(Suppl 1):S86–91.

Article  Google Scholar 

Nelson DB, Rice DC, Niu J, et al. Long-term survival outcomes of cancer-directed surgery for malignant pleural mesothelioma: propensity score matching analysis. J Clin Oncol. 2017;35(29):3354–62.

Article  PubMed  Google Scholar 

Hashimoto M, Yamamoto H, Endo S, et al. Japanese current status of curative-intent surgery for malignant pleural mesothelioma. Ann Thorac Surg. 2022;113(4):1348–53.

Article  PubMed  Google Scholar 

Baas P, Scherpereel A, Nowak AK, et al. First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743). Lancet. 2021;397(10272):375–86.

Article  CAS  PubMed  Google Scholar 

Solli P, Brandolini J, Pardolesi A, et al. Diaphragmatic and pericardial reconstruction after surgery for malignant pleural mesothelioma. J Thorac Dis. 2018;10(Suppl 2):S298–303.

Article  PubMed  PubMed Central  Google Scholar 

Bedirhan MA, Çansever L, Demir A, et al. Which type of surgery should become the preferred procedure for malignant pleural mesothelioma: extrapleural pneumonectomy or extended pleurectomy? J Thorac Disease. 2013;5(4):446–54.

Google Scholar 

Migliore M, Fiore M, Filippini T et al. Comparison of video-assisted pleurectomy/decortication surgery plus HITHOC with VATS talc pleurodesis for the treatment of malignant pleural mesothelioma. Heliyon. 2023;9(6):e16685.

Treasure T, Lang-Lazdunski L, Waller D, et al. Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma (MARS). Lancet Oncol. 2011;12(8):763–72.

Article  PubMed  PubMed Central  Google Scholar 

Weder W, Opitz I, Stahel RA, Waller DA. The MARS feasibility trial: Conclusions not supported by data. Lancet Oncol. 2011;12(12):1093–4.

Article  PubMed  Google Scholar 

Treasure T, Internullo E, Fiorentino F, et al. A survey of opinions and beliefs concerning surgery for malignant pleural mesothelioma amongst 802 members of EACTS/ESTS/STS. Interact Cardiovasc Thorac Surg. 2011;12(3):341–6.

Article  PubMed  Google Scholar 

Lim E, Darlison L, Edwards J, et al. Mesothelioma and Radical Surgery 2 (MARS 2): protocol for a multicentre randomised trial. BMJ Open. 2020;10(9):e038892. https://doi.org/10.1136/bmjopen-2020-038892.

Article  PubMed  PubMed Central  Google Scholar 

Lim E, Waller D, Lau K, et al. Extended pleurectomy decortication and chemotherapy versus chemotherapy alone for pleural mesothelioma (MARS 2). Lancet Respiratory Med. 2024;12(6):457–66.

Article  CAS  Google Scholar 

Lang-Lazdunski L. Cytoreductive surgery in diffuse pleural mesothelioma. Eur J Surg Oncol. 2025;51(8):109628. https://doi.org/10.1016/j.ejso.2025.109628.

Article  PubMed  Google Scholar 

Abdelsattar ZM, Saddoughi SA, Blackmon SH. National Cancer Database Report on Pneumonectomy Versus Lung-Sparing Surgery for Malignant Pleural Mesothelioma. Semin Thorac Cardiovasc Surg. 2019;31(2):301–9.

Google Scholar 

Williams T, Duraid H, Watson S, et al. Extended pleurectomy and decortication for malignant pleural mesothelioma is an effective and safe cytoreductive surgery in the elderly. Ann Thorac Surg. 2015;100(5):1868–74.

Article  PubMed  Google Scholar 

Orlandi R, Leuzzi G, Rolli L, et al. Long-Term Survival Analysis of Pleural Mesothelioma Patients Undergoing Surgery. Clin Lung Cancer. 2024;25(1):e5–10.

Article  PubMed  Google Scholar 

Bueno R. Why Surgery Has a Role in Pleural Mesothelioma. Ann Thorac Surg. 2025;26 July(Online ahead of print). https://doi.org/10.1016/j.athoracsur.2025.07.011.

Raskin J, van Meerbeeck J, Van Schil P. Radical surgery in pleural mesothelioma: Houston, we have a problem. J Thorac Oncol. 2025;20(5):e59–60.

Article  PubMed  Google Scholar 

Aujayeb A, Astoul P, Londero F, Zuin A. The role of surgery in pleural mesothelioma: a journey through the evidence, MARS 2 and beyond. Pulm Ther. 2025;11(2):117–27.

Article  PubMed  PubMed Central  Google Scholar 

Porcel JM. Pleural mesothelioma: surgery questioned again? Eur Respir J. 2024;63(6):2400896. https://doi.org/10.1183/13993003.00896-2024.

Article  PubMed  Google Scholar 

Pass HI, Giroux D, Kennedy C, et al. Reply to Letter: MARS 2 Findings in Context. J Thorac Oncol. 2024;20(1):e1–5.

Google Scholar 

Gulati S, Wolf AS, Flores RM. Should Treatment of Mesothelioma Include Surgery? MARS2 Fails to Land. Seminars in Thoracic and Cardiovascular Surgery; 2024.

Lim E, Opitz I, Woodard G, Bueno R, et al. A perspective on the MARS2 trial. J Thorac Oncol. 2025;20(3):262–72.

Article  CAS  PubMed  Google Scholar 

Lim E, Rogers C. Further insights into MARS 2—authors’ reply. Lancet Respir Med. 2024;12(9):e55.

Article  PubMed  Google Scholar 

Hsu DS, Kneuertz PJ. The Holy Grail of long-term survival after surgery for malignant pleural mesothelioma. Ann Thorac Surg. 2025;120(1):116–7.

Article  PubMed  Google Scholar 

Sharkey AJ, Bilancia R, Tenconi S, Nakas A, Waller DA. The management of the diaphragm during radical surgery for malignant pleural mesothelioma. Eur J Cardiothorac Surg. 2016;50(2):311–6.

Article  PubMed  Google Scholar 

Verma V, Ahern CA, Berlind CG, et al. National Cancer Database report on pneumonectomy versus lung-sparing surgery for malignant pleural mesothelioma. J Thorac Oncol. 2017;12(11):1704–14.

Article  PubMed  Google Scholar 

van Zandwijk N, Reid G, Linton A, Kao S. Radical surgery for malignant pleural mesothelioma: have we identified the appropriate selection tools? Ann Cardiothorac Surg. 2012;1(4):481–6.

PubMed  PubMed Central  Google Scholar 

Hintermair S, Iser S, Varga A, et al. Ki67 Tumour Expression Predicts Treatment Benefit Achieved by Macroscopic Radical Lung-Preserving Surgery in Pleural Mesothelioma. Cancers. 2024;16(10):1817.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Tajè R, Fiorito R, Patirelis A, Marziali V, Ambrogi V. Multifactorial evaluation following cytoreductive surgery for malignant pleural mesothelioma. J Clin Med. 2022;11(21):6418.

Article  PubMed  PubMed Central  Google Scholar 

Ho S, Culligan M, Friedberg J, et al. Examining the impact of physical function performance in predicting patient outcomes after lung-sparing surgery for malignant pleural mesothelioma. Disabil Rehabil. 2022;44(22):6676–83.

Article 

Comments (0)

No login
gif