{"entity":{"id":"pleurectomy-decortication","kind":"technology","name":"Extended pleurectomy/decortication & radical mesothelioma surgery","aka":[],"tldr":"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.","status":"historic","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Pleurectomy","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Pleurectomy"}],"tags":[],"related":[],"cancers":["mesothelioma"],"sections":["surgery"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["mars-2"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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"]},"route":"/technologies/pleurectomy-decortication/","neighbours":{"cancer":[{"id":"mesothelioma","kind":"cancer","name":"Mesothelioma","route":"/cancers/mesothelioma/"}],"section":[{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"trial":[{"id":"mars-2","kind":"trial","name":"MARS 2","route":"/trials/mars-2/"}],"bottleneck":[{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"}],"technology":[{"id":"rejuv-rehab-respiratory","kind":"technology","name":"Breathing and exercise capacity after lung resection","route":"/technologies/rejuv-rehab-respiratory/"}]}}