Improved survival with Interferon Alpha maintenance therapy following pleurectomy/decortication and radiation for malignant pleural mesothelioma. As presented by Dr. Robert Cameron. More...

Standing Strong Against Mesothelioma: California Water Works Contractor and Dr. Cameron Team Up to Remove Deadly Meso Tumor. Colfax, CA  (10/08/07)

In one hour, 68 year-old Kermit Kelley was about to undergo life-altering surgery. It was nine a.m. in the pre-op staging area at UCLA’s David Geffen School of Medicine. A steady stream of nurses and doctors had been visiting Kermit since seven o’clock, hooking him up to this, inserting that. More...

Pleurectomy/Decortication Surgery Preferable to Extra-Pleural Pneumonectomy (Sept., Oct. 2007)

The September/October issue of Thoracic Surgery News reports that the two surgical options typically used for pleural mesothelioma produce similar outcomes. However, the pleurectomy/decortication surgery spares the entire lung, and removes the the pericardium and diaphragm only when necessary.  More...

Four-modality Therapy in Malignant Pleural Msothelioma: a Phase II Study  (3/07)

Treatment approaches in malignant pleural mesothelioma (MPM) patients range from mere palliation to aggressive anticancer therapy, and there is currently no consensus on the optimal therapeutic strategy. In 1999, we began a phase II study to investigate four-modality treatment of advanced stage MPM. More...

Phase II Italian Researchers: P/D Shows Favorable Survival Rate (3/07)

Researchers at the University of Pisa in Italy have concluded in the February, 2007 issue of the Journal of Thoracic Oncology that pleurectomy-decortication surgery combined with chemotherapy produces a favorable survival rate for patient with malignant pleural mesothelioma. More...

Is Extrapleural Pneumonectomy the Preferred Surgical Management in the Multi Modal Treatment of Mesothelioma? Dr. Cameron weighs in against the EPP (Annals of Surgical Oncology, 2006)  More...

• No evidence the EPP is superior to lung-sparing P/D  
• Both surgeries carry potentially serious risks  
• Only experienced surgeons should attempt either surgery  
• "The EPP should not become the (Sir Edmund Hillary) operation of Thoracic Surgery: being done simply because it is there and because it can be done ks

Anatomy of a Successful P/D (photos).  Dr. Robert Cameron, September 13, 2005 (9/14/05)

"Rational Versus Radical Therapy For Mesothelioma: A New Approach,"  Dr. Robert Cameron, UCLA Medical School, presented at MARF Symposium in Las Vegas, October 16, 2004.  (11/18/04)  More...

"Radical Pleurectomy/Decortication and Intraoperative Radiotherapy Followed by Conformal Radiation with or without Chemotherapy for Malignant Pleural Mesothelioma" Terry T. Lee, MD, et al, J Thorac Cardiovasc Surg 2002; 124:1183-9  (Posted 5/21/04)

A retrospect review of the efficacy and morbidity of radical pleurectomy/decortication and intraoperative radiotherapy followed by external beam radiation therapy with or without chemotherapy for diffuse malignant pleural mesothelioma.  (The Journal of Thoracic and Cardiovascular Surgery - Volume 124, number 6 2002)  More...

• 32 patients with MPM studied from 1995 to 2000. Median survival from date of operation was 18.1.  Median time from operation to progression of tumor was 12.2 months.
• Local control main problem in treating MPM patients, as surgery does not eradicate all tumor.  Need for adjuvant therapy (i.e., post surgery chemo, intraoperative heated chemo perfusion, etc.)
• Median age in cohort was 69 years compared to 57 years in Sugarbaker series; median survival rates comparable (18.1 months vs. 19 months).

"A Phase II Trial of Pleurectomy/Decortication Followed by Intrapleural and Systemic Chemotherapy for Malignant Pleural Mesothelioma" V. Rusch, et al,   Journal of Clinical Oncology, Vol 12, 1156-1163, 1994  (Posted 5/21/04)

Conclusion. This short but aggressive combined modality regimen was generally well tolerated, but should not be used outside of a protocol setting because of the potential for serious toxicity. Overall survival was as good or better than with previously reported multimodality approaches, but other strategies are needed to improve local control.  More...

John R. Roberts, MD, FCCP, "Surgical Treatment of Mesothelioma: Pleurectomy"  Division of General Thoracic Surgery, Department of Cardiac and Thoracic Surgery, Vanderbilt Hospital, Nashville, TN 1999  (Posted 5/21/04)

• No studies have randomized similarly staged patients to pleurectomy or extrapleural pneumonectomy (EPP); thus the most effective surgery for patients with MPM has not been defined.

• Although no difference in overall survival between the two procedures, there was significant improvement in disease-free survival for those undergoing EPP compared with pleurectomy.

• Pleurectomy can be safely performed.  The addition of postoperative phototherapy or intrapleural chemotherapy does not improve long-term survival or result in symptom palliation.

• Limited data suggest that EPP may give greater chance of long-term survival in patients with favorable histology and earlier stage disease

M.W. Grossebner, et al, "Mesothelioma – VATS biopsy and lung mobilization improves diagnosis and palliation" Eur J Cardiothorac Surg 1999;16:619-623 (Posted 5/21/04)

Conclusions: VATs provides adequate tissue for histological diagnosis where other methods fail. At the same operative sitting it provides a therapeutic intervention that allows drainage of effusion cytoreductive pleurectomy and lung mobilization in a significant number of cases. Where the pleural space can be closed this results in significantly fewer hospital admissions and appears to improve quality of life and length of survival. The price is a longer hospital stay due to prolonged air leak. More...