Insert: Surgical Operative Procedures Suggested by an Expert

Abstract The surgical treatment of malignant pleural mesothelioma is complex and should be discussed by a multidisciplinary team. Radical surgery is limited to patients with early stage of disease and good clinical status and should be a part of multimodality approach. There are two types of surgery, lung-sacrificing (extrapleural pneumonectomy) and lung-sparing (pleurectomy/decortication). The current data does not conclusively support one operation over the other. Thus, the choice of the approach depends on the patient’s clinical condition and institutional expertise and experience. In patients with advanced stage of disease, surgery has a limited role. Palliative care and symptoms management are essential while debulking surgery should be considered in very select cases or to obtain an adequate specimen for diagnosis.