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
  • Pneumonia
  • 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 jenna@mesotheliomaguide.com.

    Sources & Author

Devin Goldan image

About the Writer, Devin Golden

Devin Golden is the 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.

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    Sources & Author

Picture of Devin Golden

About the Writer, Devin Golden

Devin Golden is the 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.