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mesothelioma pathway

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					                                            MESOTHELIOMA PATHWAY FOR MID-TRENT LUNG CANCER NETWORK
                                                                                       HISTOLOGICAL DIAGNOSIS OF
                                                                                             MESOTHELIOMA



                                                                         PS 0-1                             PS 2+



                      Epitheliod confirmed & patient would consider surgery
                                                                                                                                             Non-epitheliod cell type
                                                                                                                                              unwilling for surgery
                                   Lung function Echo


                                       Fit for surgery


                                             Staging                                                                         unfit for surgery
                                            CT +/- PET



                       T1-3 N0-1                                       T4 N2
                   tumour resectable                            tumour unresectable


                   Offer MARS



 Accepts MARS                      Rejects MARS



  Staging as per                                                      Pleurodesis
     protocol                                                      MESO-VATS trial
                                       Radical                    VATS pleurectomy /                                Indwelling              palliative                port-site RT
                                     decortication                    decortication                                 drain                 chemotherapy             (if not receiving
No EPP out of trial                No EPP out of trial              Indwelling drain                                                        (? in trial)           chemotherapy)

				
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posted:11/16/2010
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Description: mesothelioma