Mesothelioma treatment options such as chemotherapy, immunotherapy and radiation therapy can help patients, but they require multiple cycles, can last multiple weeks, and can give people a few months of improved life expectancy.

Surgery for mesothelioma only takes hours, can remove most or all of the tumors, and can give patients the most time possible with friends and family, making this treatment a preferred option when possible.

A new study published in the Annals of Thoracic Surgery affirms this.

The study compared the survival results of patients with pleural mesothelioma who chose to have surgery versus those who did not. The results showed the significant benefit surgery can be for people’s mesothelioma life expectancy.


Two Surgeries for Pleural Mesothelioma

There are two options for pleural mesothelioma surgery: extrapleural pneumonectomy (EPP); and pleurectomy with decortication (P/D). EPP involves removing the affected lung along with pleura, which is the lining of the lungs where the disease forms. Mesothelioma tumors usually spread from this lining toward the lungs.

P/D removes the pleura and possibly part of the diaphragm. However, it does not involve removing either lung.

Deciding which surgery a patient should have depends on the patient’s preference, the stage of the disease, whether tumors have spread to the lung, and the cancer center and specialist performing surgery. Some specialists and cancer centers prefer EPP while others prefer P/D.


Deciding Whether to Have Mesothelioma Surgery

Not all people with pleural mesothelioma are eligible to have surgery. Eligibility often depends on the stage or the patient’s overall health. For instance, people who are not healthy enough to fully recover from having an entire lung removed may not be recommended for surgery.

Additionally, people diagnosed with stage 3 mesothelioma or stage 4 mesothelioma might not benefit from surgery as the disease may have spread to other organs. Mesothelioma can spread to both lungs, making surgery difficult or putting an unnecessary burden on the patient’s physical well-being. Tumors can also spread to the spine or brain, which also excludes surgery as a mesothelioma treatment option.

For people who are healthy enough and with an early enough stage of mesothelioma to have surgery, the data suggests moving forward with an operation.


Mesothelioma Survival After Surgery

The study analyzed the effect of pleural mesothelioma surgery. Patients received chemotherapy first, then either had surgery or refused it.

The study looked at 296 cases of pleural mesothelioma where surgery was offered: 272 agreed to surgery and 24 refused it. The large majority (75%) of surgery patients had P/D, while 15.8% had EPP and only 9.2% had an exploratory thoracotomy, which is a surgical procedure involving an incision between the ribs that allows surgeons to examine the lung cavity and learn the extent of the disease and how far tumors have spread.

Patients who had mesothelioma surgery significantly outperformed those who did not:

  • Median overall survival of 40.7 months for people who had surgery
  • Median overall survival of 23.6 months for people who refused surgery
  • Median progression-free survival of 20.2 months for having surgery
  • Median progression-free survival of 12.9 months for refusing surgery

People diagnosed with mesothelioma can easily find a cancer center to learn if they’re eligible for surgery. The first step is contacting Mesothelioma Guide’s team of patient advocates for expert help finding a cancer hospital specializing in mesothelioma. Email our lead patient advocate and registered nurse Karen Ritter at to begin your journey fighting mesothelioma.

Sources & Author

  1. Impact of Surgery on Disease Progression and Survival of Patients with Pleural Mesothelioma. Annals of Thoracic Surgery. Retrieved from: Accessed: 03/13/2024.
Devin Golden

About the Writer, Devin Golden

Devin Golden is a content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.