How Old is Too Old to Operate for Mesothelioma?

Excerpt

Malignant pleural mesothelioma (MPM) is a highly lethal cancer which, to date, has seen few improvements in overall survival despite best practices. Owing in part to the rarity of the disease, there is a paucity of evidence-based data from adequately powered randomized trials, and no consensus regarding optimal multimodal treatment. Surgical management strategies, including extrapleural pneumonectomy and pleurectomy decortication, have been widely employed as part of this treatment paradigm. While surgery has been demonstrated (in nonrandomized series) to provide a survival benefit in highly selected patients, the data suffer from the lack of standardized surgical techniques and expertise.1‐3 As such, careful patient selection remains at the center of our treatment algorithm and is a critical determinant of overall patient outcome. …