With the incidence of mesothelioma in the United Kingdom (UK) expected to attain epidemic proportions over the next 20 years, prospective randomised evaluation of the role of surgery in the treatment of mesothelioma is required so that appropriate resource planning can be made. Possible prospective trials to evaluate the role of radical surgery are proposed together with the principles which must be conceded in the approach to radical surgery, patient selection, resectability, operability, treatment modalities, debulking surgery, chemotherapy and radiotherapy.
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