Surgery is the best remedy for mesothelioma. The treatment removes a large chunk of the tumors from the body, instantly improving the chances of beating this cancer.
Mesothelioma stubbornly doesn’t quit, though, and has high rates of recurrence. Even after surgery, tumors can form and spread again within a few years.
So that leaves the question: Should patients undergo surgery again?
An article in the Interactive Cardiovascular Thoracic Surgery publication dove into this exact topic. Most mesothelioma specialists are against two aggressive surgeries, but the authors of this report indicate it could help.
Findings From the Research
The authors combed through more than 2,000 studies involving macroscopic complete resection of mesothelioma. This type of surgery could be an:
- Extrapleural pneumonectomy, which removes the lung, pleura, diaphragm and pericardium
- Pleurectomy with decortication, which removes the pleura and possibly the diaphragm and pericardium
- Cytoreduction, which also removes the peritoneum
The authors found three studies involving a second surgery for curative intent. The two largest included 16 patients each meeting this criteria. The surgery could be cytoreduction, which is just noticeably removing visible tumors, or it could be a pleurectomy.
One study had 16 chest wall resections of mesothelioma recurrence. No one died during the operation, while the other study had two.
The survival rate was of note from one study in particular. The survival after the second surgery was much better than for patients receiving chemotherapy, radiation or no follow-up treatment:
- 16 months for a second surgery
- 9 months for second-line therapy
- 2 months for no therapy
The third and final study analyzed included just eight patients. The median time to recurrence was 29 months — meaning it took that long after the first surgery to see signs of the cancer spreading again.
The survival after the second surgery was 14.5 months, again much better than second-line treatment.
“In patients presenting with recurrence of mesothelioma after an MCR procedure, radical surgery to resect the recurrent tumor could have a role in improvement of survival in selected patients,” the authors wrote. “Positive prognostic factors include epithelioid pathology and a longer disease-free interval after the first procedure.”
Sources & Author
- Recurrence of mesothelioma after a macroscopic complete resection procedure: is a second radical surgery justified? Interactive Cardiovascular Thoracic Surgery. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/33496324/. Accessed: 02/03/2021.