Dr. Giuseppe Cardillo of Carlo Forlanini Hospital in Rome and Dr. Tom Treasure with University College London have detailed their finding in a letter to editor in the Annals of Surgery. The doctors acknowledged that there were some findings where extrapleural pneumonectomy (EPP) was effective but they point out that many of these studies were flawed and failed to probably account for the grim post-op experience of the patients.
EPP is the most invasive and radical form of surgery used to treat pleural mesothelioma. This extensive surgery involves removal of one lung as well as the diseased pleural membrane, all or part of the diaphragm, the pericardial membrane around the heart, as well as other at-risk tissues. Anytime so such an invasive procedure is performed there always exists a high risk of complications or infection.
Pleurectomy with decortication (PD) is a slightly less extensive procedure which involves the same removal of diseased tissues however it leaves the lungs intact.
The letter concludes that "The accumulated evidence points away from EPP as clinically effective and, if taken in its totality."
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