Mesothelioma Therapy Surgical Treatment Options 2 — Questions and Answers
Question 1: VATS (Video-Assisted Thoracoscopic Surgery) is most commonly used for mesothelioma in which context?
- Curative resection
- Diagnostic biopsy and pleurodesis (Correct answer)
- Lymph node dissection
- Pericardectomy
Correct answer: Diagnostic biopsy and pleurodesis
VATS is primarily used for diagnostic biopsy and pleurodesis in mesothelioma rather than curative resection.
Question 2: What is pleurodesis used for in mesothelioma management?
- Removing the tumor entirely
- Preventing recurrent pleural effusion (Correct answer)
- Delivering chemotherapy to the pleura
- Staging the cancer
Correct answer: Preventing recurrent pleural effusion
Pleurodesis is a palliative procedure used to prevent recurrent pleural effusion by causing the pleural layers to adhere together.
Question 3: Which structure is NOT typically removed during an Extrapleural Pneumonectomy (EPP)?
- Ipsilateral lung
- Pericardium
- Diaphragm
- Contralateral lung (Correct answer)
Correct answer: Contralateral lung
EPP involves removal of the ipsilateral lung, pleura, pericardium, and diaphragm—the contralateral lung is always spared.
Question 4: What is the main advantage of P/D over EPP?
- Lower recurrence rates
- Preservation of the lung and better quality of life (Correct answer)
- Shorter operation time
- More complete lymph node removal
Correct answer: Preservation of the lung and better quality of life
P/D preserves the lung, generally resulting in better postoperative quality of life and lower mortality risk compared to EPP.
Question 5: In the trimodality therapy approach for mesothelioma, what is the correct order of treatments?
- Radiation → Surgery → Chemotherapy
- Surgery → Chemotherapy → Radiation
- Chemotherapy → Surgery → Radiation (Correct answer)
- Surgery → Radiation → Chemotherapy
Correct answer: Chemotherapy → Surgery → Radiation
The classic trimodality approach is chemotherapy (neoadjuvant) → EPP (surgery) → radiation therapy to the hemithorax.
Question 6: Which complication is most common after EPP surgery?
- Deep vein thrombosis
- Atrial fibrillation (Correct answer)
- Wound infection
- Pulmonary embolism
Correct answer: Atrial fibrillation
Atrial fibrillation is the most common complication after EPP, occurring in up to 40% of patients due to surgical manipulation near the pericardium.
Mesothelioma Therapy Surgical Treatment Options 2
VATS (Video-Assisted Thoracoscopic Surgery) is most commonly used for mesothelioma in which context?