The hope is mesothelioma survival rates improve as time passes. The only way to accomplish this feat is by introducing new therapies and enhancing current ones.
Pleurectomy with decortication, a popular surgery for pleural mesothelioma, is a perfect example.
A new report, which includes specialist Dr. Raphael Bueno and the late Dr. David Sugarbaker as authors, analyzes 355 cases of pleurectomy with decortication (P/D) for pleural mesothelioma. The report was published in Annals of Surgery and details a 5-year survival rate “approaching 25%.” That number is an improvement from past studies.
What Are the Survival Rates for P/D?
The reported median survival after P/D was 20.7 months. Nearly 18% survived for five years. Not all patients had a complete resection, though. Of the 304 who did, the median survival was 23.2 months with a 21.2% 5-year survival rate.
The goal is complete macroscopic resection of the disease. Pleural mesothelioma starts in the pleura, a thin lining separating your lung cavity and chest wall. The pleura has two layers of tissue with a narrow fluid-filled space in between.
Tumors develop here and eventually can spread towards the lungs. P/D’s goal is to remove the pleura, thus removing the tumors, and peel off any tumors on the outside of the lungs.
However, the surgery leaves both lungs intact, a contrast from extrapleural pneumonectomy (the other main operation for pleural mesothelioma). More doctors prefer P/D as it’s easier for the body to handle.
Research mostly backs up P/D in the debate. In four different studies conducted between 2008 and 2016, the mortality rates for P/D were significantly lower than EPP. The median survival rates were close to even.
In those past studies, the median survival after P/D was 12-16 months. This new study is at least a six-month improvement.
Factors Affecting Survival After P/D
Most of the patients in this study had the more-favorable epithelioid cell type, ideal for aggressive surgery. However, the majority of patients were also male, which traditionally results in a decreased survival rate.
Other predominant survival factors for mesothelioma are stage and post-surgery treatment. For instance, patients who had adjuvant chemotherapy or intraoperative heated chemotherapy survived longer. More than half of patients with a stage 1 disease and epithelioid cell type survived for five years.
The 30-day and 90-day mortality rates were low: 3% and 4.6%, respectively. The reported complications mostly mild forms of:
- Air leaks
- Blood clots (potentially affecting an artery)
- Irregular heart rate
- Chylothorax (lymphatic fluid leaking into pleural space)
- Pus gathering in the pleural space
- Blood accumulating in the pleural space
We can help you find a surgeon who excels at P/D for mesothelioma. Contact our medical experts to learn if you’re a candidate for this type of surgery. Our registered nurse and lead patient advocate, Jenna Campagna, is available by email at firstname.lastname@example.org.
Sources & Author
- Pleurectomy Decortication in the Treatment of Malignant Pleural Mesothelioma. Annals of Surgery. Retrieved from: https://journals.lww.com/annalsofsurgery/Abstract/9000/Pleurectomy_Decortication_in_the_Treatment_of.93886.aspx. Accessed: 12/07/2020.
- Extrapleural pneumonectomy (EPP) vs. pleurectomy decortication (P/D). Annals of Translational Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497106/. Accessed: 12/07/2020.
Sources & Author