Pleurectomy/Decortication (P/D)
Pleurectomy/decortication is a lung-sparing surgical procedure for pleural mesothelioma that removes the pleural lining and all visible tumor while preserving the underlying lung. It may include removal of the diaphragm and pericardium (extended P/D). It offers a less radical alternative to EPP with lower surgical morbidity.
P/D has become increasingly favored over EPP at many mesothelioma centers because it preserves lung function while still achieving significant tumor removal. The surgery involves stripping the diseased parietal pleura from the chest wall and peeling (decorticating) the visceral pleura from the lung surface, removing all visible tumor.
Extended P/D includes removal of the diaphragm and/or pericardium when tumor has invaded these structures, followed by reconstruction with synthetic patches. Even with extended resection, preserving the lung results in better post-operative quality of life and lower operative mortality compared to EPP.
Like EPP, P/D is most effective as part of a multimodal treatment plan combining surgery with chemotherapy and/or radiation therapy. Candidates should have early-stage (stage I–III) disease, predominantly epithelioid cell type, and adequate overall health. Compare surgical options at EPP vs. pleurectomy.
- Also known as
- P/D, Extended pleurectomy/decortication, Extended P/D
- Category
- Treatment
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