In a departure from standard mesothelioma treatment practices in the United States, the British Thoracic Society has published new treatment guidelines that recommend against radical surgical options.
The Mesothelioma Management Guidelines just published by the British Thoracic Society now recommend against aggressive surgery to treat advanced mesothelioma.The decision follows an analysis of the potential harm and poor outcomes experienced by patients undergoing extra pleural pneumonectomy (EPP), extended pleurectomy and decortication (P/D), and partial pleurectomy (PP), which are frequently offered in the United States. The British society makes an exception when such procedures are being conducted as part of a specific study or clinical trial. A recent report in the Clinical Respiratory Journal, which correlated hundreds of previous studies and clinical trials, concluded such aggressive surgical options were not providing enough benefits to offset adverse effects. The new guidelines explicitly recommend against offering EPP at all pleural mesothelioma patients, against offering EPD unless as part of a clinical trial, and that radiation therapy should only be used with the goal of offering pain relief and quality of life improvement rather than for a curative approach.