Recurrence Patterns and Management after Pleurectomy Decortication for Pleural Mesothelioma.

Objective: We hypothesize that recurrence following pleurectomy decortication (PD) is primarily local. We explored factors associated with tumor recurrence patterns, disease-free interval (DFI), and post-recurrence survival (PRS).

Summary Background Data: Tumor recurrence is a major barrier for long-term survival after pleural mesothelioma (PM) surgery.

A Perspective on the MARS2 Trial.

Introduction: The phase 3 randomized controlled trial of extended pleurectomy decortication and chemotherapy versus chemotherapy alone for pleural mesothelioma (PM) (MARS2) reported "extended pleurectomy decortication was associated with worse survival to 2 years, and more serious adverse events for individuals with resectable PM, compared with chemotherapy alone." These results have led to considerable discourse regarding the future role of surgery for PM, and there has not been unanimity in the mesothelioma surgical community regarding the trial interpretation. This "perspective" evaluates MARS2 using internationally renowned PM experts who either agreed with the trial interpretation or who found issues with its conduct which may have influenced the results.

The Role of Endobronchial Ultrasound for Mediastinal Staging in Mesothelioma.

Background: Invasive mediastinal staging is a crucial component of the preoperative evaluation for potential surgical candidates with pleural mesothelioma (PM). Endobronchial ultrasound (EBUS) is less invasive than mediastinoscopy for staging; however, its accuracy in patients with PM remains undefined. We present our institutional experience with EBUS staging in patients with PM.