Researchers compared less invasive surgery to traditional surgery (MPM). Between July 2004 and April 2016, they looked at a group of patients with MPM. Chemotherapy (neoadjuvant and adjuvant) and surgery with or without 54 Gy hemithoracic radiation were used to treat the patients. Patients were divided into three groups according to the type of operation they were having: Group 1 (before August 2009) was to have conventional extrapleural pneumonectomy; Group 2 (after September 2009) was to have less invasive extrapleural pneumonectomy, and Group 3 was to have pleurectomy/decortication (after September 2012). They studied 152 individuals, the majority of whom had epithelioid subtypes (median age 64 [37–71] years; 131 men, 21 women) (91.4%). Among them, 149 (98.0%) received neoadjuvant chemotherapy, while 117 (77.0%) had surgery (60 extrapleural pneumonectomy and 57 pleurectomy/decortication).

Macroscopic complete resection was obtained in 94.9% of cases (111/117), with mortality rates of 1.7% (2/117) and 3.4% (4/117) at 30 and 90 days, respectively. All 152 patients had a median survival time of 34.9 months and a progression-free survival time of 17.4 months, respectively. Groups 1, 2, and 3 had median survival times of 18.5, 41.9, and 43.4 months, respectively. Groups 1, 2, and 3 had progression-free survival of 12.0, 24.5, and 21.8 months, respectively. Less invasive surgery for MPM resulted in fewer surgical risks and equivalent or higher survival when compared to traditional surgical procedures.