The uniquely diffuse nature of malignant pleural mesothelioma (MPM) makes it difficult to diagnose, stage, and treat. In addition, it is a relatively uncommon disease, making adequate prospective trials difficult to perform and leading to several controversies regarding the best management of MPM. Perhaps the greatest area of dispute is whether extrapleural pneumonectomy or pleurectomy/decortication is the most appropriate curative operation for patients who are physiologically candidates for both. Although median survival remains poor, important strides have been made in the treatment of MPM, mainly in the form of multimodality therapeutic regimens.
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