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Pleural mesothelioma 

Pleural mesothelioma
Chapter:
Pleural mesothelioma
Author(s):

Andrea S. Wolf

, Assunta de Rienzo

, Raphael Bueno

, Lucian R. Chirieac

, Joseph M. Corson

, Elizabeth H. Baldini

, David Jackman

, Ritu Gill

, Walter Weder

, Isabelle Opitz

, Ann S. Adams

, and David J. Sugarbaker

DOI:
10.1093/med/9780199656103.003.0048
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date: 23 October 2019

Occupational and environmental exposure to asbestos is a global health problem; mesothelioma can be traced to the mining and manufacture of asbestos. Moreover, asbestos use continues unabated in many developing regions of the world ensuring that this epidemic will certainly continue for decades beyond current projections. The current multimodality approach to malignant pleural mesothelioma (MPM) is defined as a macroscopic complete resection (MCR) such as extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D), followed or preceded by some form of therapy for micrometastatic control. The latter usually consists of adjuvant or neoadjuvant chemotherapy and radiation (trimodal therapy), but novel approaches are also being investigated, such as heated intracavitary chemotherapy, photodynamic therapy, and novel radiation techniques. Concurrent developments in diagnostic procedures, histopathologic characterization of mesothelial cells, and staging have improved patient selection, but more research is needed to extend survival by limiting the micrometastatic spread of tumours.

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