Written By: David Statman
Epithelioid Mesothelioma Prognosis
When people are diagnosed with mesothelioma, they are usually told the type of mesothelioma they have, the cell type and their prognosis. Epithelioid mesothelioma is one of the cell types of this cancer, and the prognosis for epithelioid mesothelioma is typically better than the other two cell types: sarcomatoid and biphasic.
Medically Reviewed By
Karen Ritter, RN BSN
Registered Nurse
Medically Reviewed By
Karen Ritter, RN BSN
Registered Nurse
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Important Facts About Epithelioid Mesothelioma Prognosis
- A prognosis is given to patients by their doctor. The prognosis for mesothelioma is based on a few factors, including the cell type.
- Epithelioid mesothelioma has the best prognosis because of how the cells appear and spread. Epithelioid mesothelioma tumors are easier to remove during surgery than the other cell types.
- A prognosis is not an exact determination of your life expectancy. Many patients far outlive their prognosis due to lifestyle changes, successful treatments, and more factors.
What Is a Prognosis for Cancer?
A prognosis for cancer is a medical forecast of how the disease will progress and a timeline for how quickly the cancer will spread. Part of a cancer prognosis includes a medical forecast of the outcome, including the length of survival.
This forecast is not an exact science and is merely used to set patient expectations. A prognosis for a specific type of cancer is usually based on data from past cases with similar characteristics: stage, age, overall health and treatment plan.
What Is the Usual Prognosis for Epithelioid Mesothelioma?
The prognosis for epithelioid mesothelioma ranges from 10-20 months. Epithelioid mesothelioma has the best average prognosis of the three cell types. According to the Orphanet Journal of Rare Diseases, most patients who survive for two years after their diagnosis have epithelioid mesothelioma.
Fortunately, epithelioid mesothelioma is the most common cell type. People with mesothelioma receive an epithelioid mesothelioma diagnosis in up to 70% of cases.
Epithelioid mesothelioma has the best prognosis because it’s the easiest to treat with surgery. Epithelioid mesothelioma cells are well-defined and easily identifiable in tests of tissue samples. They have well-defined nuclei, pink cytoplasm, and elongated egg shape. They also don’t metastasize as quickly as other cell types.
Most patients have epithelioid pleural mesothelioma, which means the cancer forms in the lining of the lungs (pleura). The other common place epithelioid mesothelioma forms is in the lining of the abdominal cavity (peritoneum). The prognosis is usually better for patients with epithelioid peritoneal mesothelioma than for patients with epithelioid pleural mesothelioma.
Survival Rates for Epithelioid Mesothelioma
Epithelioid mesothelioma usually has the best survival rate because it responds to treatment better, spreads slowly, and tumors are easily detectable on scans and during surgery.
Survival rates for epithelioid mesothelioma can significantly improve with successful surgery. One study found that epithelioid pleural mesothelioma patients’ survival improved from 20-25 months due to successful mesothelioma surgery.
Immunotherapy for epithelioid pleural mesothelioma has had a positive impact. Opdivo and Yervoy, two FDA-approved immunotherapies for mesothelioma, led to an average survival of 19 months for patients with epithelioid pleural mesothelioma who couldn’t have surgery. This length is 3-5 months longer than the average for patients who receive just chemotherapy.
Survival Rates by Type of Mesothelioma
The most significant factor for prognosis is where the patient’s mesothelioma forms. There are three types of mesothelioma:
Pleural mesothelioma
Forms in the pleura, which is the lining of the lungs.
Peritoneal mesothelioma
Forms in the peritoneum, which is the lining of the abdominal cavity.
Pericardial mesothelioma
Forms in the pericardium, which is a sac around the heart.
The average prognosis is better for epithelioid peritoneal mesothelioma than for epithelioid pleural mesothelioma:
- According to a study published on UpToDale, epithelioid pleural mesothelioma patients survive for an average of 19 months.
- According to a different study, epithelioid peritoneal mesothelioma patients survived for an average of 55 months.
There is not enough data about epithelioid pericardial mesothelioma, as this type of mesothelioma is very rare. Less than 1% of people with mesothelioma have pericardial mesothelioma.
Other Factors Affecting an Epithelioid Mesothelioma Prognosis
There are a few factors affecting a prognosis for epithelioid mesothelioma. The main factors are:
The patients stage of mesothelioma
Treatment options available to the patient
Age and overall health of the patient
Stage
The stage of mesothelioma has a huge impact on the prognosis for a patient with this cancer and cell type.
Stage 1 is the earliest of the four stages of mesothelioma and has the best prognosis. Patients diagnosed in this stage usually live for around two years after the diagnosis.
Stage 4 is the most advanced stage. Patients diagnosed in this stage usually live for 8-10 months after the diagnosis.
Treatment
Epithelioid mesothelioma treatment also affects the prognosis because some treatment options lead to longer survival. For instance, patients who have a successful surgery usually live for 2-3 years after the operation. Patients who undergo chemotherapy or immunotherapy, without surgery, live for 14-18 months.
Part of an epithelioid mesothelioma prognosis is the patient’s quality of life while living with the cancer. This includes recovering from surgery or any potential long-term complications from surgery. For instance, one surgery for mesothelioma (extrapleural pneumonectomy surgery) removes one of the lungs. This can impact a patient’s breathing and exercise tolerance.
Age and Health
If the patient is in poor health, then their prognosis usually worsens. The overall health of the patient can limit the treatment options for the patient. Age is not always a factor, but it’s sometimes tied to health. A lot of older patients are not healthy enough to undergo surgery or tolerate chemotherapy.
Frequently Asked Questions About Epithelioid Mesothelioma Prognosis
What is the Usual Prognosis for Epithelioid Mesothelioma?
Your prognosis for epithelioid mesothelioma cancer depends on a few factors, such as your age, health, the stage of your mesothelioma, and your treatment options. A major factor is where the cancer forms. If it forms in the pleura (lining of the lungs), then the prognosis will be different than if it forms in the peritoneum (lining of the abdominal cavity).
What Is the Average Survival for Epithelioid Mesothelioma?
The average survival for mesothelioma is 1-2 years. Epithelioid mesothelioma has the best prognosis of the three cell types (the other two are sarcomatoid mesothelioma and biphasic mesothelioma). The average survival for epithelioid pleural mesothelioma, according to one study, is 19 months.
Sources & Author
- Presentation, initial evaluation, and prognosis of malignant pleural mesothelioma. UpToDate. Retrieved from: https://www.uptodate.com/contents/presentation-initial-evaluation-and-prognosis-of-malignant-pleural-mesothelioma?topicRef=4625&source=see_link. Accessed: 04/17/19.
- Malignant peritoneal mesothelioma: Epidemiology, risk factors, clinical presentation, diagnosis, and staging. UpToDate. Retrieved from: https://www.uptodate.com/contents/malignant-peritoneal-mesothelioma-epidemiology-risk-factors-clinical-presentation-diagnosis-and-staging. Accessed: 12/16/19.
- Malignant mesothelioma. Orphanet Journal of Rare Diseases. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652430/. Accessed: 10/04/19.
AI Summary of Epithelioid Mesothelioma Prognosis
When diagnosed with epithelioid mesothelioma, understanding the prognosis can help patients and their families gain a clearer perspective on the disease's expected progression and treatment outlook. The prognosis for epithelioid mesothelioma is generally more favorable compared to other types of mesothelioma because of the way the cells grow and respond to treatment. This cell type tends to be less aggressive, easier to identify during testing, and can often be more effectively removed through surgery, which contributes to a better overall outlook. It is important to remember, however, that a prognosis is not an exact prediction of life expectancy, but rather an estimate based on previous cases with similar characteristics and treatment responses.
The typical survival time for someone with epithelioid mesothelioma ranges from about 10 to 20 months. Many patients who survive beyond two years tend to have the epithelioid cell type, underscoring its comparatively better prognosis among mesothelioma types. The most common form of this disease is pleural mesothelioma, which forms in the lining of the lungs, but it can also develop in the lining of the abdominal cavity, known as peritoneal mesothelioma. Prognosis tends to be more favorable for those with peritoneal mesothelioma, with some studies reporting survival times averaging over four years, compared to approximately 19 months for pleural cases. The prognosis is generally better in the earlier stages of the disease and can be improved through treatments such as surgery, chemotherapy, and immunotherapy.
Several factors influence the outlook for an individual with epithelioid mesothelioma. The stage of the disease at diagnosis is paramount; early-stage diagnosis often leads to better treatment options and longer survival. The availability and success of treatments, including successful surgical removal of tumors, also play a crucial role in extending life expectancy. A patient’s age and overall health status further impact prognosis, as healthier patients are more likely to tolerate aggressive treatment options. In contrast, those in poor health or older age may face limits in treatment choices, which can lower the expected survival time. While these factors influence prognosis, it is essential to understand that each person's case is unique, and many factors can affect the overall outlook. Patients should consult with their healthcare team to discuss their specific situation and plan appropriate care accordingly.