The Society of Thoracic Surgeons 2026 Expert Consensus on the Multimodal Treatment of Pleural Mesothelioma

A newly published expert consensus statement from the Society of Thoracic Surgeons provides updated guidance on the treatment of pleural mesothelioma, a rare and aggressive cancer that develops in the lining of the lungs. Developed by an international panel of thoracic surgeons, oncologists, radiation specialists, radiologists, and pathologists, the consensus reflects a comprehensive review of current evidence and offers recommendations for diagnosis, staging, and treatment. 

One of the report’s key messages is that pleural mesothelioma should be managed by a multidisciplinary team with expertise in mesothelioma care. Treatment decisions should involve specialists from multiple fields to ensure that patients receive individualized care based on their disease characteristics and overall health status. The panel also emphasizes the importance of obtaining adequate tissue biopsies and performing comprehensive staging, including CT and PET imaging scans, before treatment decisions are made. 

The consensus strategy strongly supports a multimodal treatment approach, meaning that surgery, when appropriate, should be combined with other therapies such as chemotherapy, immunotherapy, or radiation therapy rather than used alone. Importantly, the panel concluded that surgery continues to have a role for carefully selected patients despite ongoing debate surrounding its benefits. 

Among patients considered candidates for surgery, the panel favors lung-sparing procedures such as pleurectomy/decortication and extended pleurectomy/decortication over extrapleural pneumonectomy, which involves removal of a whole lung. The greatest potential benefit appears to occur in patients with epithelioid mesothelioma, localized disease, good performance status, and adequate cardiopulmonary function. Overall, this consensus statement reinforces the importance of expert, multidisciplinary, and individualized care while providing a contemporary framework for the treatment of pleural mesothelioma. 

If you or a loved one has been diagnosed with pleural mesothelioma, understanding your medical and legal options is important. Brayton Purcell LLP represents individuals and families affected by asbestos-related diseases and can help you evaluate whether exposure to asbestos may be connected to your diagnosis. Contact our team today for a free, confidential case review.