Perspective on malignant pleural mesothelioma diagnosis and treatment

Malignant pleural mesothelioma (MPM) is an aggressive solid malignancy with dismal prognosis. The majority of newly diagnosed MPM patients present with advanced (IMIG/UICC stage IV) disease and are therefore treated with chemotherapy and supportive measures. The median survival of this group of patients ranges from 12 months with chemotherapy to 7 months with supportive care (1,2). Nonetheless, for a selected group of patients that present with a locally advanced disease (IMIG/UICC stage I–III), a personally tailored multimodality therapeutic (MMT) protocol comprising of cyto-reductive surgery and chemotherapy with or without radio-therapy may be the best therapeutic option. Although MMT is also associated with high rates of morbidity and mortality, it remains the sole option to significantly extend the survival of patients that physically and clinically qualify for this aggressive treatment strategy (3-8) .