Mesothelioma Therapy Surgical Treatment Options 1 — Questions and Answers
Question 1: Which surgery is considered the most aggressive and potentially curative procedure for pleural mesothelioma?
- Pleurectomy/Decortication (P/D)
- Extrapleural Pneumonectomy (EPP) (Correct answer)
- Video-Assisted Thoracoscopic Surgery (VATS)
- Debulking surgery
Correct answer: Extrapleural Pneumonectomy (EPP)
Extrapleural Pneumonectomy (EPP) is the most aggressive surgery, involving removal of the affected lung, pleura, diaphragm, and pericardium.
Question 2: What does Pleurectomy/Decortication (P/D) involve?
- Removal of the entire lung
- Removal of the pleura while sparing the lung (Correct answer)
- Removal of the diaphragm only
- Removal of mediastinal lymph nodes
Correct answer: Removal of the pleura while sparing the lung
P/D involves removing the diseased pleural lining while preserving the lung, offering a lung-sparing alternative to EPP.
Question 3: Which patient characteristic is most important when determining surgical eligibility for EPP?
- Age over 65
- Adequate cardiopulmonary reserve (Correct answer)
- BMI greater than 30
- Previous chemotherapy
Correct answer: Adequate cardiopulmonary reserve
Adequate cardiopulmonary reserve is the most critical factor, as EPP is a major surgery requiring the patient to function with one lung.
Question 4: Which surgical approach is most commonly used for peritoneal mesothelioma?
- EPP
- Cytoreductive surgery (CRS) with HIPEC (Correct answer)
- P/D
- Thoracotomy
Correct answer: Cytoreductive surgery (CRS) with HIPEC
Cytoreductive surgery combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is the preferred surgical approach for eligible peritoneal mesothelioma patients.
Question 5: What is the primary goal of debulking surgery in mesothelioma?
- Complete cure
- Reducing tumor burden to improve quality of life and treatment response (Correct answer)
- Replacing chemotherapy entirely
- Eliminating lymph node metastases
Correct answer: Reducing tumor burden to improve quality of life and treatment response
Debulking surgery aims to reduce tumor burden, which can relieve symptoms and improve the efficacy of subsequent treatments.
Question 6: Which factor most contraindicates surgical resection in mesothelioma patients?
- Stage I disease
- Epithelioid cell type
- Distant metastatic disease (Stage IV) (Correct answer)
- Age 50–60
Correct answer: Distant metastatic disease (Stage IV)
Distant metastatic disease (Stage IV) typically contraindicates curative surgical resection as the cancer has spread beyond the reach of surgery.
Mesothelioma Therapy Surgical Treatment Options 1
Which surgery is considered the most aggressive and potentially curative procedure for pleural mesothelioma?