Mesotheliomas

Pleurectomy and lung decortication is a surgical procedure used to treat pleural mesothelioma, a cancer that affects the parietal and visceral pleura, the membranes lining the chest wall and the lungs.

During the procedure, the surgeon removes the entire pleura along with any surrounding tissue affected by the tumor.

The goal of this surgery is to remove as much tumor tissue as possible while preserving the underlying lung, helping to relieve symptoms such as chest pain and pleural effusion (accumulation of fluid in the chest cavity).

In selected cases, the procedure may be extended to include the removal of adjacent organs or structures involved by the disease.

In selected cases, pleurectomy may be extended to include resection of the diaphragm, as mesothelioma can spread to and infiltrate this muscle, which separates the thoracic and abdominal cavities.

The procedure involves the partial or complete removal of the diaphragm, followed by reconstruction, with or without the use of a prosthetic mesh.

If mesothelioma spreads to the pericardium, the membrane surrounding the heart, pericardiectomy may be required.

This procedure involves the surgical removal of the affected portion of the pericardium, followed by reconstruction using a synthetic or biological prosthesis.

In advanced cases of pleural mesothelioma, when the tumor extensively involves one lung, pneumonectomy may be necessary.

This procedure involves the surgical removal of the entire affected lung in an effort to achieve the most effective local control of the disease.

Hyperthermic intrathoracic chemotherapy (HITOC) can be performed in conjunction with pleurectomy and lung decortication.

Following surgical removal of the tumor, a chemotherapy solution heated to 41-42°C is circulated directly within the chest cavity for approximately 60 minutes. This approach aims to destroy any remaining cancer cells and enhance local disease control.

Surgical treatment of mesothelioma is typically part of a multimodal treatment strategy, combining surgery with other therapies such as systemic therapy and radiation therapy to improve overall treatment effectiveness and provide a more comprehensive approach to disease management.

The choice of treatment depends on several factors, including the stage and extent of the disease, the patient’s overall health status, and individual preferences.

Pleurectomy and lung decortication is a surgical procedure used to treat pleural mesothelioma, a cancer that affects the parietal and visceral pleura, the membranes lining the chest wall and the lungs.

During the procedure, the surgeon removes the entire pleura together with any adjacent tissue involved by the tumor.

The aim of this surgery is to remove the tumor while preserving the underlying lung, helping to relieve symptoms such as chest pain and pleural effusion (accumulation of fluid in the chest cavity).

In selected cases, the procedure may be extended to include the removal of adjacent organs affected by the disease.

In selected cases, pleurectomy and lung decortication may be extended to include resection of the diaphragm, as mesothelioma can spread to and infiltrate this muscle, which separates the thoracic and abdominal cavities.

The procedure involves the partial or complete removal of the diaphragm, followed by reconstruction, with or without the use of a prosthetic implant.

If mesothelioma spreads to the pericardium, the membrane surrounding the heart, pericardiectomy may be required.

This procedure involves the surgical removal of the affected pericardium, followed by reconstruction using a synthetic or biological prosthesis.

In very advanced cases of pleural mesothelioma, when the tumor extensively involves one lung, pneumonectomy may be necessary.

This procedure involves the surgical removal of the entire affected lung as part of the treatment strategy for selected patients.

Hyperthermic intrathoracic chemotherapy (HITOC) can be performed in conjunction with pleurectomy and lung decortication.

Following surgical removal of the tumor, a chemotherapy solution heated to 41-42°C is circulated directly within the chest cavity for approximately 60 minutes. The aim of this procedure is to destroy any remaining cancer cells and improve local disease control.

Surgical treatment of mesothelioma is typically part of a multimodal approach, combining surgery with other therapies such as systemic therapy and radiation therapy to enhance overall treatment effectiveness and provide more comprehensive disease management.

The choice of treatment depends on several factors, including the stage and extent of the disease, the patient’s overall health status, and individual preferences. Surgical management is determined according to the staging and extent of the tumor.

This surgery is used to treat pleural mesothelioma, which affects the membrane lining the inner wall of the chest wall and lungs (parietal and visceral pleura).

During pleurectomy, the surgeon removes all of the pleura and surrounding tissue affected by the cancer.

This surgery aims to remove the tumor without removing the underlying lung in order to relieve associated symptoms, such as chest pain and fluid accumulation in the chest (pleural effusion).

Pleurectomy can sometimes be enlarged by removing neighboring organs involved in the disease.

Pleurectomy may be expanded to the diaphragmatic muscle in some cases because mesothelioma can spread and infiltrate this anatomical structure that separates the thoracic and abdominal cavities. Surgical excision involves excision of part or all of the diaphragm and its reconstruction with or without prosthetic replacement.

If mesothelioma spreads to the pericardium (the membrane that surrounds the heart), surgical removal of the affected pericardium and its replacement by synthetic or biological prostheses may be necessary.

In very advanced cases of pleural mesothelioma in which the tumor significantly involves one lung, it may be necessary to remove the entire affected lung surgically.

This procedure can be performed in conjunction with pleurectomy. After surgical removal of the tumor, a chemotherapy solution heated to 41°/42° for about 60 minutes is circulated directly into the chest cavity to produce the death of any remaining cancer cells. Surgical treatment of mesothelioma is usually part of a multimodal approach, that is, combined with other forms of therapy, such as chemotherapy and radiation therapy, to improve the overall effectiveness of treatment and to manage the disease more comprehensively. The choice of treatment depends on several factors, including the stage of the tumor, the patient’s overall health, and personal preference. Surgical treatment of mesothelioma depends on the staging of the disease and its extent.

This surgery is used to treat pleural mesothelioma, which affects the membrane lining the inner wall of the chest wall and lungs (parietal and visceral pleura).

During pleurectomy, the surgeon removes all of the pleura and surrounding tissue affected by the cancer.

This surgery aims to remove the tumor without removing the underlying lung in order to relieve associated symptoms, such as chest pain and fluid accumulation in the chest (pleural effusion).

Pleurectomy can sometimes be enlarged by removing neighboring organs involved in the disease.

Pleurectomy may be expanded to the diaphragmatic muscle in some cases because mesothelioma can spread and infiltrate this anatomical structure that separates the thoracic and abdominal cavities. Surgical excision involves excision of part or all of the diaphragm and its reconstruction with or without prosthetic replacement.

If mesothelioma spreads to the pericardium (the membrane that surrounds the heart), surgical removal of the affected pericardium and its replacement by synthetic or biological prostheses may be necessary.

In very advanced cases of pleural mesothelioma in which the tumor significantly involves one lung, it may be necessary to remove the entire affected lung surgically.

This procedure can be performed in conjunction with pleurectomy. After surgical removal of the tumor, a chemotherapy solution heated to 41°/42° for about 60 minutes is circulated directly into the chest cavity to produce the death of any remaining cancer cells. Surgical treatment of mesothelioma is usually part of a multimodal approach, that is, combined with other forms of therapy, such as chemotherapy and radiation therapy, to improve the overall effectiveness of treatment and to manage the disease more comprehensively. The choice of treatment depends on several factors, including the stage of the tumor, the patient’s overall health, and personal preference. Surgical treatment of mesothelioma depends on the staging of the disease and its extent.

Thanks to the large number of cases treated each year, the Candiolo Cancer Institute is a national reference center for the care of this disease. This extensive experience allows us to manage even the most complex cases, always using a personalized approach, tailored to the clinical and individual profile of each patient.

Establishing a treatment plan always begins with an accurate and timely diagnosis. Patients have access to state-of-the-art imaging technologies, such as ultrasound, contrast-enhanced CT, MRI, and cholangio-RM, which are critical for accurately assessing the extent of the tumor.

Advanced laboratory tests, including molecular analyses, are also available to help define biological features of the disease and guide treatment choices.

When appropriate, surgeries are performed using minimally invasive, laparoscopic or robotic techniques. These approaches involve the use of camera-equipped instruments introduced into the abdomen through small incisions, thus reducing surgical trauma. Benefits to the patient include shorter hospital stay times, faster recovery, and lower risk of complications compared with traditional open surgery.

As an IRCCS (Scientific Institute for Research, Hospitalization, and Healthcare), the Candiolo Cancer Institute combines clinical care with a strong focus on scientific research. Patients can be considered for participation in active clinical trials, offering access to innovative therapies not yet available in standard practice. This integration of care and research is a distinctive strength that translates into tangible benefits for patients.

The Interdisciplinary Care Group (GIC or MDT) supports the patient at every stage: from diagnosis, through treatment, to follow-up. Special attention is paid to nutritional support, psychological health and reintegration into daily life. The organization of checkups, examinations, and treatment is designed to ensure continuity, serenity, and a humane, caring approach to each patient’s needs.