# Extended pleurectomy/decortication & radical mesothelioma surgery

Source: https://onco.cc/technologies/pleurectomy-decortication/  
OnCo record `pleurectomy-decortication` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Pleurectomy and decortication are operations that strip the tumour-bearing lining from the lung and chest wall. They were long assumed to help; the MARS 2 trial showed they do not.

## Summary

Extrapleural pneumonectomy (removing lung, pleura, diaphragm, pericardium) was largely abandoned after MARS 1 (2011) showed high mortality without benefit. Lung-sparing extended pleurectomy/decortication remained standard in selected centres until MARS 2 (2024) showed worse survival and quality of life with surgery plus chemotherapy than chemotherapy alone. Surgery now has a limited role: diagnosis, palliation (pleurodesis, indwelling catheters), and trials.

## Fields

- Kind: Technology
- Status: historic
- Last checked: 2026-09-07
- Principle: Macroscopic complete resection of parietal and visceral pleura with or without lung; usually within multimodality therapy.
- Strengths: Symptom relief in trapped lung; Tissue for diagnosis and research
- Limitations: No survival benefit in randomised trials; Significant morbidity and quality-of-life cost

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Pleurectomy
- Wikipedia: https://en.wikipedia.org/wiki/Pleurectomy

## Connected records

- cancers: [Mesothelioma](https://onco.cc/cancers/mesothelioma/)
- fronts: [Surgery & Interventional](https://onco.cc/fronts/surgery/)
- trials: [MARS 2](https://onco.cc/trials/mars-2/)
- bottlenecks: [Surgery and radiotherapy cure most, get least](https://onco.cc/bottlenecks/b-surgery-radiation-innovation/)
- technologies: [Breathing and exercise capacity after lung resection](https://onco.cc/technologies/rejuv-rehab-respiratory/)

---
JSON: https://onco.cc/api/v1/entities/pleurectomy-decortication.json