It is a pleasure to serve as guest editor for this issue of the Annals of Cardiothoracic Surgery devoted to the management of malignant pleural mesothelioma (MPM). Although an uncommon malignancy in North America, MPM is being seen with increasing frequency in other areas around the world where asbestos exposure, the most common risk factor for MPM, remains a significant problem. During the past 15 years, pervasive nihilism about MPM has yielded to a better understanding of this difficult disease and excitement about new treatment opportunities. Better methods of pathological diagnosis, improved ways to stage this tumor, decreasing surgical morbidity and mortality, the development of effective multimodality therapy and an emerging understanding of tumor biology have dramatically changed the approach to MPM worldwide. Long-term survival in MPM is still poor, but a vibrant field of translational and clinical research has made available to patients an array of new treatment options. Indeed, the breadth of ongoing research in MPM makes it challenging to cover all aspects of management and new therapies within a single journal issue.
Many leading investigators have contributed to this issue of the Annals to provide an overview of the state of the art in translational research and clinical care in MPM. In addition to chapters that highlight various areas such as epidemiology, biomarkers, prognostic factors and multimodality therapy, videos showing the techniques for extended pleurectomy/ decortication and extrapleural pneumonectomy are included. I am indebted to the Editors-in-Chief, especially Dr. Tristan Yan, for the opportunity to serve as guest editor and for his active support of the development of this journal issue. I am grateful to all of my colleagues who generously shared their expertise and thank them for contributing. We hope that practicing thoracic surgeons will find this issue to be a valuable resource in the care of our patients with MPM.
Disclosure: The author declares no conflict of interest.