What Is a Mesothelioma Extrapleural Pneumonectomy?
A mesothelioma extrapleural pneumonectomy (EPP) is a type of mesothelioma surgery used for those in the early stages of pleural mesothelioma.
EPP is an invasive surgery that involves:
- Opening the chest cavity either through the front (a sternotomy) or on the side (a thoracotomy) and making a 9-inch incision
- Removing all visual signs of cancer including the entire diseased lung as well as cancerous tissue on the pleural lining of the chest, heart, and diaphragm
- Chemotherapy and sometimes radiation therapy before and after surgery for best results.
Because the surgery is so radical, candidates must be in overall good health with strong heart function and a remaining healthy and functioning lung.
While extrapleural pneumonectomy is considered curative in that it seeks to remove all present pleural mesothelioma and extend a person’s life, it poses significant risks such as internal bleeding, respiratory failure, and even death.
Extrapleural pneumonectomy differs from another similar surgery, pleurectomy/decortication (P/D), in that P/D spares the lung and only removes the membrane surrounding the lungs.
According to a medical review published in the journal Lung Cancer, the median survival rate of patients who had an EPP was 12-22 months compared to 13-29 months for P/D.
The medical community is still debating which is preferable since the extrapleural pneumonectomy may remove more cancer, but poses a much higher risk than the less invasive P/D.
Quick Facts About Extrapleural Pneumonectomy
- The first EPP was performed on a mesothelioma patient in 1976.
- Extrapleural pneumonectomies are always performed with chemotherapy and sometimes radiation before, during, or after surgery.
- According to the American Cancer Society (ACS), about 1 in 3 patients who have an EPP may experience major complications.
- Extrapleural pneumonectomy is a potentially curative surgery and has offered some people long periods without cancer, according to the ACS.