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Study: Lung removal does not significantly reduce quality of life for mesothelioma patients


A seven-year Italian study found that mesothelioma patients who underwent lung-removal surgery can still enjoy an “acceptable” quality of life.


The surgery, a pneumonectomy, involves the removal of an entire lung and is mostly employed when the disease is confined to one lung only. The Italian study enrolled 71 lung cancer and mesothelioma patients who underwent the procedure between January 2003 and March 2010.


More than 90 percent of the patients enrolled in the study were still alive after one year. About 20 percent survived at least five years. Patients in both groups developed a heart condition called tricuspid valve insufficiency, in which some blood passes from the right ventricle to the right atrium, the opposite of the normal direction, causing decrease in heart function.


Nonetheless, based on patient questionnaires, the researchers concluded the condition was not serious enough to significantly decrease their quality of life. “Postoperative mortality (4.3%) and five-year survival (20%) after pneumonectomy seem to be satisfactory,” they wrote.


The findings were published in the Italian surgical journal Minerva Chirurgica. The study, conducted by thoracic surgeons from the Faculty of Medicine and Surgery at the University of L'Aquila in Teramo, Italy, comes as clinicians continue to debate surgical options for mesothelioma patients.


Some surgeons say lung removal carries a much greater risk of severe complications and death in mesothelioma patients. They have advocated pleurectomy/decortication, or P/D, a less-invasive procedure that involves removing the lung lining and any tumors inside the lining. Studies have found that, when employed in conjunction with radiation and chemotherapy, P/D has a median survival rate of more than 20 months, with fewer complications.


A study published in the April issue of Journal of Thoracic Oncology suggested that patients with early-stage pleural mesothelioma might be better off forgoing an extrapleural pneumonectomy, an aggressive surgery that involves removing the lung, chest lining and diaphragm, in favor of the less radical procedure.