Extrapleural Pneumonectomy (EPP) reduces pulmonary function of mesothelioma patients

The Asian Cardiovascular and Thoracic Annals can reveal that patients who opt for pleural/decortication (P/D) has more chances of enjoying a more comfortable life compared to patients who undergo extrapleural pneumonectomy (EPP).

Pleural mesothelioma originates from the skinny lining that wraps the lungs. Since it is very near the lungs, there is a high probability that pleural mesothelioma will eventually extend to the lung itself, thus, undermining the latter’s function. In the long run, the diseased mesothelium eventually thickens and hardens, thus, preventing the lungs’ expansion every time a patient breathes.

Pleurectomy/decortication and extrapleural pneumonectomy are the two major types of surgical treatments offered to mesothelioma patients. However, the medical community is divided as to which of the two offers better relief to the patients. While both operations are invasive in nature and aim to eliminate diseased pleural tissue, studies show that only extrapleural pneumonectomy can remove the diseased lung, the lymph nodes, parts of the covering of the heart (pericardium) and part if not all of the diaphragm, too.

Researchers at the University Medical Center in Freiburg, Germany studied the conditions of 48 patients with mesothelioma on one side of their chest. Twenty-five of the patients had undergone EPP; 23 had lung-sparing P/D. Researchers also looked into the patient’s medical history, the type of mesothelioma they had, their survival, and lung function both before and after surgery.

Findings can reveal that EPP is not “worth the pain, risk and potentially life-altering side effects for mesothelioma patients.” The Freiburg research team assessed the lung function of the patients after surgery and found out that that those who had undergone EPP “had a harder time breathing afterward” compared to patients who opted pleurectomy/decortication.

The report reveals that a total lung capacity in the EPP group “differed significantly” after surgery. It plummeted from 77.7% before surgery to 55.3% afterwards. While an average, healthy person has a median vital capacity (the amount of air a person can exhale after a breathing) of 3 to 5 liters, an individual who underwent EPP only has 2.8 L preoperatively, the rate dropping to 1.8 L after EPP.

These disturbing results prompted the researchers to conclude that, since EPP “significantly reduced pulmonary function” for mesothelioma patients who had undergone through it, likely expected to manifest shortness of breath. This could have a negative effect on their quality of life.