What criteria do you use to select which patients with thoracic mesothelioma to send for an extrapleural pneumonectomy or pleurectomy/decortication?

We approach each patient's case individually when considering multi-modality treatment of pleural mesothelioma; multi-disciplinary communication and planning is vital prior to the initiation of any therapy.

Patients with stage IIIA disease or less with epithelioid or biphasic (with predominant epithelioid component) histology are considered. Workup will include invasive mediastinal staging by EBUS or mediastinoscopy and in some cases laparoscopy if abdominal disease is suspected. The surgeon mu...