Treatment
There is no globally accepted, standardized guideline for the treatment of MPM that is adapted to the tumor stage – however, it is generally accepted that monotherapy alone is not sufficient for this aggressive tumor. According to current international guidelines (1-4), macroscopic complete resection in a multimodal treatment concept is the consensus recommendation. Most centers currently combine macroscopically complete resection with neoadjuvant (before surgery) or adjuvant (after surgery) chemotherapy. The combination of cisplatin and pemetrexed is considered to be the gold standard, as it offers the best chances of survival (on average twelve months with a response rate of 40%) and the best quality of life. Gemcitabine has comparable activity, but is less well tolerated.
Operational procedures
Pleurectomy/decortication or extrapleural pneumonectomy
A macroscopically complete resection can be achieved with a lung-preserving, extended pleurectomy/decortication (P/D) or an extrapleural pneumonectomy (EPP). In EPP, the pleura (= pleura), one lung, the pericardium (= pericardial sac) and the diaphragm (= diaphragm) are removed. In P/D, the same operation is performed with the difference that the lung tissue is almost completely preserved.
praxis gesundheit program on the topic of "Absbest - deadly consequences"
In the program praxis Gesundheit on the subject of “Absbest – deadly consequences”, Prof. Dr. Isabelle Schmitt-Opitz and the wife of an asbestos victim talk about asbestos, the diagnosis of malignant pleural mesothelioma and the consequences of this deadly disease.