2026-02-12 マウントサイナイ医療システム(MSHS)
<関連情報>
- https://www.mountsinai.org/about/newsroom/2026/mount-sinai-study-strengthens-landmark-evidence-supporting-lung-sparing-surgery-offering-hope-for-mesothelioma-patients
- https://www.annalsthoracicsurgery.org/article/S0003-4975(26)00105-0/abstract
MARS2の惨事?胸膜中皮腫手術の現代における成果から学ぶ教訓 Disaster on MARS2? Lessons Learned from Modern Day Outcomes of Surgery for Pleural Mesothelioma
Shubham Gulati, MS ∙ Andrea Wolf, MD ∙ Jai Mehrotra-Varma, BS ∙ Stephanie Tuminello, PhD ∙ Emanuela Taioli, MD PhD ∙ Raja Flores, MD
The Annals of Thoracic Surgery Published:February 2, 2026
DOI:https://doi.org/10.1016/j.athoracsur.2026.01.025
Graphical abstract
ABSTRACT
BACKGROUND
The Mesothelioma and Radical Surgery 2 (MARS2) trial has drawn into question pleurectomy/decortication (PD) for the treatment of pleural mesothelioma. This trial’s evaluation of resectability (poor PET-CT utilization, patients with non-epithelioid subtypes, etc.) and preference for extended PD (89% patients underwent this) may have led to the high in-hospital and 30-day mortality (both 4%) and 90-day mortality (9%). Many argue that surgical treatment for mesothelioma offers better outcomes in appropriately identified patients. The argument is based on case series prior to 2015 with limited discussion of surgical details. We present our institutional outcomes in carefully-characterized pleural mesothelioma during the time MARS2 was completed, highlighting management and outcomes in the same period.
METHODS
Our database was screened for patients from 2015-2021 treated with PD for pleural mesothelioma. Patients undergoing extrapleural pneumonectomy were excluded. Electronic medical records were queried for dates of surgery, last follow-up, and death; preoperative tests; operative details; and postoperative outcomes. Electronically available obituaries were reviewed to supplement survival data. Descriptive variables and post-surgical survival were analyzed.
RESULTS
Seventy-one patients underwent PD for pleural mesothelioma. Histological diagnosis demonstrated 56 (78.9%) epithelioid, 13 (18.3%) biphasic, and 2 (2.8%) sarcomatoid PM. All 71 (100%) had pulmonary function tests and PET-CT. In-hospital and 30-day mortality were 0 and 90-day mortality was 3/71 (4.2%).
CONCLUSIONS
PD can be done safely, with low post-operative mortality. With strict selection criteria and resection focused on balancing cytoreduction with patients’ tolerance for aggressive surgery, short-term complications and mortality of PD in pleural mesothelioma can be limited.
