2500-3000 cases per year in US. Incidence is rising and expected to peak in 2025.
90% of cases are attributed to asbestos exposure
Tumor spreads along chest tube and biopsy tracks
Epithelioid histology has a better prognosis than sarcomatoid or mixed types
Definitive surgery is extrapleural pneumonectomy; adjuvant radiation is often given (45Gy)
Pemetrexed and cisplatin chemotherapy improves survival (compared with cisplatin alone) in non-surgical patients
Avoid contralateral lung if giving postoperative RT
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