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Surgery for Epithelioid Mesothelioma

Epithelioid mesothelioma is a rare and aggressive form of cancer that primarily affects the mesothelial cells lining the lungs and other organs. Treatment for epithelioid mesothelioma typically involves a multimodal approach, which may include surgery, chemotherapy, radiation therapy, and other supportive treatments. Surgery is often a crucial component of the treatment plan, but it’s important to note that the specific surgical options and their appropriateness may vary depending on the individual patient’s condition and the stage of the disease.

Here are some common surgical approaches used in the treatment of epithelioid mesothelioma:

  1. Pleurectomy/Decortication (P/D): This is a lung-sparing surgery in which the surgeon removes the cancerous tissue, including the pleura (the lining around the lungs), but tries to preserve as much lung function as possible. P/D is typically considered for early-stage epithelioid pleural mesothelioma.
  2. Extrapleural Pneumonectomy (EPP): In EPP, the surgeon removes the entire affected lung along with the pleura, diaphragm, and nearby lymph nodes. This procedure is more aggressive and may be considered for patients with more advanced disease or when the tumor cannot be safely removed with a pleurectomy/decortication.
  3. Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC): For peritoneal epithelioid mesothelioma (affecting the lining of the abdomen), CRS with HIPEC may be an option. This involves removing visible tumors from the peritoneal cavity and then administering heated chemotherapy directly into the abdominal cavity to kill any remaining cancer cells.
  4. Lymph Node Dissection: Lymph nodes in the chest or abdomen may also be removed during surgery to determine if the cancer has spread to nearby lymph nodes.

It’s important to emphasize that not all patients with epithelioid mesothelioma are suitable candidates for surgery. The decision to undergo surgery depends on various factors, including the stage of the disease, the patient’s overall health, and the expertise of the surgical team. Additionally, surgery is often used in combination with other treatments like chemotherapy and radiation therapy to increase the chances of a successful outcome.

After surgery, patients will typically require a period of recovery and may continue with additional treatments as part of their overall treatment plan. The choice of treatment and its success can vary from person to person, so it’s essential for individuals diagnosed with epithelioid mesothelioma to consult with a multidisciplinary team of medical professionals to develop a personalized treatment plan that offers the best possible outcome.

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