Robert J. Ginsberg, MD

Drs. Zellos and Sugarbaker have provided a concise yet complete review of the current management of resectable diffuse malignant mesothelioma and have identified areas worthy of further investigation. Although, on occasion, surgical treatment can produce long-term cure, in general, diffuse malignant mesothelioma is a devastating disease. One only has to look at the survival curves provided by the Brigham group to understand that, of 183 patients, only 7 survived for 5 years.[1] However, neither the number eligible for evaluation at 5 years nor the disease-free survival figures were reported.

Drs. Matin and Goldberg describe and comment on the invasive techniques currently used for the clinical staging of lung cancer. Although they term this “surgical” staging, in reality, it is part of clinical staging (cTNM) and should be distinguished

The 1997 revision of the lung cancer staging system has added very little to disease staging, and many changes have been totally unnecessary. Before the next revision of the staging system, anticipated in the year 2007, a