胸膜切除术和脱皮（P/D）和胸膜外肺切除术（EPP）是手术pleural mesothelioma。两个都手术旨在去除尽可能多的肿瘤组织。为此，P/D和EPP去除肺部外围的组织（胸膜）。P/D手术没有继续去除受影响的肺部。EPP手术确实消除了受影响的肺。
Doctors have debated the merits of these two surgeries for years, trying to determine which is best. No clear answer has ever surfaced. However, a recent study indicates P/D may be the better option for many万博专业版间皮瘤患者。
什么是P/D？
胸膜切除术和脱皮（P/D）是手术治疗用于胸膜间皮瘤。万博专业版该手术清除了肺周围的衬里（胸膜）。
扩展pleurectomy and decortication (EPD)是一项更具侵略性的手术。除了去除肺部外衬里外，EPD还去除了心脏周围的衬里（心包）。如果外科医生认为这是必要的，EPD也可以清除全部或部分膜片。
According to experts, the goal of P/D is宏观完整切除（MCR）。MCR is a medical term for complete or near-complete removal of all tumor tissue. Simply put, P/D attempts to physically remove as much cancer as possible.
Reported survival for pleural mesothelioma patients undergoing P/D or EPD ranges from 10 to 29 months. Doctors have reported median survival up to 57 months for patients undergoing P/D within a多模式治疗计划。
中位生存
研究中一半患者的时间点仍然活着。
什么是胸膜外肺切除术（EPP）？
胸膜外肺切除术（EPP）is also a surgical treatment for pleural mesothelioma. Like P/D, EPP removes the pleura, the pericardium and affected portions of the diaphragm. However, EPP goes further than P/D by removing the affected lung as well.
专家说，EPP对术后生理有重大影响。失去肺部会降低一个人的心血管功能。在某些情况下，它也可能对生活质量产生负面影响。
Given the nature of the surgery, EPP is considered a higher risk procedure than P/D. However, experts say the elevated risk of EPP comes with a higher chance of complete tumor removal.
Reported survival for pleural mesothelioma patients undergoing EPP ranges from 12 to 22 months. Doctors have reported median survival of up to 39 months for patients treated with EPP combined with other treatments, such aschemotherapy。
患者应通过狗万 。
胸膜切除术和脱毛（P/D）和胸膜外肺切除术（EPP）之间有什么区别？
P/D。and EPP have a variety of differences that fall into three categories: surgical procedure, eligibility and side effects.
总体而言，EPP比P/D更具侵略性，风险更高。万博专业版间皮瘤医生仍在争论哪种手术为胸膜间皮瘤患者提供了最佳选择。万博专业版但是，最近的一项研究已经阐明了这个主题。
2021年研究说，P/D应该是可手术胸膜间皮瘤的主要手术方法万博专业版
研究人员在德克萨斯大学医学博士安德森癌症中心已经执行P/D和EPP至少20年。他们最近出版了他们程序的结果from January 2000 to June 2019. During that time period, 282 pleural mesothelioma patients were treated with P/D or EPP.
| MD Anderson胸膜切除术和胸膜外肺切除术研究中的患者特征 | ||
|---|---|---|
| P/D患者 | EPP患者 | |
| ＃治疗 | 95 | 187 |
| 中年的 | 65年 | 61years |
| 接受了术前化疗 | 83％ | 34％ |
| 接受术后辐射 | 56％ | 64% |
研究人员研究了匹配队列的结果 - 一组具有匹配属性的患者，例如年龄和癌症阶段。匹配的队列将P/D患者与特征相似的EPP患者进行了比较。匹配的队列的创建是为了帮助消除研究结果中的潜在缺陷。
在匹配的队列中，median survival for P/D was 22 months. Median survival for EPP was 13 months.P/D。also appeared superior in terms of perioperative mortality. 11% of EPP patients died during or soon after surgery. None of the P/D patients died during this same time period.
In all their analyses, the study authors did not find “any oncological benefit” of either surgery over the other. The authors noted the goal of pleural mesothelioma surgery should be to remove as much cancer, as safely as possible. Although EPP potentially removes more cancer, it also demonstrated a higher risk of perioperative complications and death. As such, they concluded that future studies should focus on P/D as the main surgical approach.
Which Is Better: Pleurectomy and Decortication (P/D) or Extrapleural Pneumonectomy (EPP)?
Speaking generally, recent studies support more widespread application of P/D rather than EPP. The American Society of Clinical Oncology recommends P/D or EPD as the first choice over EPP as well. Some experts go further, claiming EPP should be abandoned altogether and “consigned to the surgical history books.”
Still, the ultimate decision should be made on an individual basis. Patients considering either procedure should discuss their options with a top mesothelioma surgeon.
