Pleural mesothelioma patients often face a high rate of recurrence after surgery. The goal of mesothelioma surgery is to accomplish complete macroscopic resection. However, most surgeons are not focused on lymph nodes in the spaces between the rib cage because they have never been a part of cancer staging.

Pleural mesothelioma specialist, Dr. Joseph Friedberg out of the University of Maryland School of Medicine, recently conducted a study showing that these lymph nodes routinely carry metastatic disease. He and his team are the first to discover the importance of this group of lymph nodes.

Improving Mesothelioma Survival

The average life expectancy for a pleural mesothelioma patient receiving chemotherapy is 12-18 months. Patients who qualify for surgery often see these statistics double.

Dr. Friedberg is advising other physicians to pay attention to the posterior intercostal lymph nodes as they will play a significant role in staging of the cancer and determining a treatment plan.

Dr. Friedberg and his team of researchers found that the risk of recurrence or death was twice as high in patients whose posterior intercostal lymph nodes were affected by their cancer. 7% of the patients in the study had no other spread of their cancer, except for the lymph nodes between the ribs.

“Although larger studies are needed, we believe that these lymph nodes should routinely be removed during any surgery with therapeutic intent for malignant pleural mesothelioma, especially as they may be the only lymph nodes to harbor metastatic disease,” says Dr. Friedberg.

Importance of Seeking Out a Mesothelioma Specialist

With pleural mesothelioma accounting for roughly 75% of 3,300 diagnoses each year, it is vital to find a doctor who expertise is mesothelioma treatment. Dr. Friedberg is an expert in mesothelioma surgery, specializing in the lung-sparing pleurectomy with decortication (P/D). Throughout his career, he has experimented with multi-modal therapy and has seen great results.

In combining the P/D surgery with photodynamic therapy and chemotherapy, he has seen patients have a median survival of 3 years with some patients living longer than 7 years.

With Dr. Friedberg’s findings, we hope to see a reduction in mesothelioma recurrence and an improvement in mesothelioma survival post surgery. The posterior intercostal lymph nodes should be identified on diagnostic scans and taken into consideration when deciding upon a treatment plan.

Jenna Campagna, RN - Patient Advocate

My name is Jenna Campagna, I am a registered nurse and a mesothelioma patient advocate. I can help you navigate your treatment options and get you connected to a mesothelioma specialist. Do not hesitate to contact me by phone 888-385-2024 x 102 or by email

    Sources & Author

Picture of Jenna Campagna, RN

About the Writer, Jenna Campagna, RN

Jenna Campagna is a registered nurse and patient advocate who is passionate about helping mesothelioma patients navigate their health care. She has over seven years of experience working with patients diagnosed with rare diseases including mesothelioma. Jenna is also a member of the Academy of Oncology Nurse & Patient Navigators and her goal is to connect patients to top mesothelioma specialists, treatment facilities, and clinical trials. Through her writing, she aims to simplify the complicated journey through mesothelioma by offering helpful tips and advice.