{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:58:10Z","timestamp":1780513090356,"version":"3.54.1"},"reference-count":20,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The benefit of surgery for malignant pleural mesothelioma is highly debated, as few robust clinical trials show its effectiveness. Objective: To examine the long-term survival of patients with malignant pleural mesothelioma who underwent surgical treatment combined with neoadjuvant chemotherapy versus those who received chemotherapy alone. Methods: We analyzed a historical cohort of 122 patients diagnosed with mesothelioma, confirmed through histopathological examination. We compared the clinical and laboratory characteristics of the surgery and chemotherapy groups at baseline. We calculated Kaplan\u2013Meier survival curves and used Cox\u2019s proportional hazards model to evaluate the relationship between surgery and mortality. Results: Surgery was performed in 16 out of 122 cases. Pleurectomy\/decortication (PD) represented 8 cases, while extrapleural pneumonectomy (EPP) accounted for the remaining 8 cases. At five years, survival rates for those who underwent surgery compared to chemotherapy alone were 53% (95% CI 15\u201381%) versus 23% (95% CI 10\u201340%), respectively. Survival among those who had PD was 67%, compared to 40% for those who had EPP. Surgical treatment was associated with improved survival, with a hazard ratio (HR) of 0.34 (95% CI 0.19\u20130.61) after adjusting for factors such as age over 65, the duration from symptom onset to diagnosis, hemoglobin levels below 10 g, a neutrophil-to-lymphocyte ratio over 6, and ECOG scores greater than 2. Conclusions: Mesothelioma surgery, whether it be PD or EPP, enhances patients\u2019 survival compared to chemotherapy. PD produces better outcomes than EPP.<\/jats:p>","DOI":"10.3390\/cancers17142360","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T08:24:17Z","timestamp":1752654257000},"page":"2360","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of Surgical Treatment on Survival of Patients with Malignant Pleural Mesothelioma"],"prefix":"10.3390","volume":"17","author":[{"given":"Renata","family":"B\u00e1ez-Salda\u00f1a","sequence":"first","affiliation":[{"name":"Teaching Department, Instituto Nacional de Enfermedades Respiratorias, Ismael Cos\u00edo Villegas, Mexico City 14080, Mexico"},{"name":"Divisi\u00f3n de Posgrado, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Esther","family":"Marmolejo-Torres","sequence":"additional","affiliation":[{"name":"Teaching Department, Instituto Nacional de Enfermedades Respiratorias, Ismael Cos\u00edo Villegas, Mexico City 14080, Mexico"},{"name":"Divisi\u00f3n de Posgrado, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City 04510, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Antonio","family":"I\u00f1iguez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Divisi\u00f3n de Posgrado, Facultad de Medicina, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Mexico City 04510, Mexico"},{"name":"Thoracic Surgery Department, Instituto Nacional de Enfermedades Respiratorias, Ismael Cos\u00edo Villegas, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9565-4178","authenticated-orcid":false,"given":"A\u00edda","family":"Jim\u00e9nez-Corona","sequence":"additional","affiliation":[{"name":"Departamento de Epidemiolog\u00eda Ocular y Salud Visual, Instituto de Oftalmolog\u00eda, Fundaci\u00f3n Conde de Valenciana IAP, Mexico City 06800, Mexico"},{"name":"Direcci\u00f3n General de Epidemiolog\u00eda, Secretar\u00eda de Salud, Mexico City 01480, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Alberto","family":"Berrios-Mej\u00eda","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Instituto Nacional de Enfermedades Respiratorias, Ismael Cos\u00edo Villegas, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"ref_1","unstructured":"International Agency for Research on Cancer (2023, October 21). 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