{"entity":{"id":"paper-mars-2-lancet-respir-med-2024","kind":"paper","name":"MARS 2: extended pleurectomy decortication plus chemotherapy versus chemotherapy alone for pleural mesothelioma","aka":[],"tldr":"Adding lung-sparing radical surgery to chemotherapy for pleural mesothelioma did not lengthen life; patients who had surgery lived slightly less long, had more complications and worse quality of life, so routine surgery is no longer recommended.","summary":"Multicentre randomised trial in the United Kingdom of 335 patients with resectable pleural mesothelioma randomised to extended pleurectomy decortication plus platinum-pemetrexed chemotherapy or chemotherapy alone.\n\nMedian overall survival was 19.3 months with surgery against 24.8 months without (hazard ratio 1.28); surgery caused more serious adverse events and worse quality of life in the first year, at higher cost.","asOf":"2026-09-17","links":[{"label":"Lancet Respir Med 2024","url":"https://doi.org/10.1016/S2213-2600(24)00119-x"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/38740044/"}],"tags":[],"related":[],"cancers":["pleural-mesothelioma"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["mars-2"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"The Lancet Respiratory Medicine","year":2024,"doi":"10.1016/S2213-2600(24)00119-x","pmid":"38740044","authors":"Lim E, Waller D, Lau K, et al.","paperType":"rct","findings":["Median overall survival 19.3 vs 24.8 months; hazard ratio 1.28 favouring no surgery.","Serious adverse events 3.6 times more common in the surgery arm."],"whatItMeans":"Radical surgery for pleural mesothelioma should be confined to trials; effusion is managed with pleurodesis or indwelling catheters and treatment is systemic.","caveats":["Surgical quality varied across centres; proponents argue selected patients in expert hands may still benefit.","Most patients had epithelioid disease."],"changedPractice":true,"participants":335},"route":"/key-papers/paper-mars-2-lancet-respir-med-2024/","neighbours":{"cancer":[{"id":"pleural-mesothelioma","kind":"cancer","name":"Pleural mesothelioma","route":"/cancers/pleural-mesothelioma/"}],"trial":[{"id":"mars-2","kind":"trial","name":"MARS 2","route":"/trials/mars-2/"}]}}