Prospective randomised controlled trial of video assisted thorascopic (VATS) cytoreductive pleurectomy compared to talc pleurodesis in patients with suspected or proven malignant mesothelioma

The principal aim of this study is to compare the effectiveness of video-assisted thoracoscopic (VAT) cytoreductive pleurectomy against talc pleurodesis for patients with pleural effusion secondary to mesothelioma We have chosen pleurodesis with talc (either via an intercostal chest drain or during thoracoscopy) as the principal control group because these are widely available and commonly used treatments for management of malignant pleural effusion. The Primary objective is to compare the effectiveness of talc pleurodesis against video-assisted thoracoscopic cytoreductive surgery in terms of survival at one year.