A recent study showed that pleural mesothelioma patients treated with surgery-based multimodality therapy live almost 9 months longer. Multimodality therapy refers to treating patients with several different types of treatment. A combination of surgery, chemotherapy, and radiation therapy, called trimodality, is especially effective.

Comparing Mesothelioma Treatment Options

A recent study analyzed 6,645 cases of malignant pleural mesothelioma by using the National Cancer Database. The study analyzed 10 years worth of data and was run by the MD Anderson Cancer Center in Houston, Texas. MD Anderson is well known for their cancer research and commonly hosts mesothelioma trials.

The goal of the study was to see how cancer-directed surgery affected survival. Researchers also wanted to compare surgery alone to surgery combined with other treatments.

Out of 6,645 pleural mesothelioma patients:

  • 2,166 patients had no therapy
  • 2,015 had chemotherapy alone
  • 850 underwent surgery alone
  • 988 had surgery & chemotherapy
  • 274 underwent trimodality therapy (chemotherapy, surgery, and radiation)
  • 352 received another combination of chemotherapy, surgery, and/or radiation

According to the study, the most effective type of treatment is surgery-based multimodal therapy. Surgery-based multimodal therapy can improve survival and offer therapeutic benefit to eligible patients. The most effective type of multimodal therapy is trimodality with chemotherapy, surgery, and radiation.

Median survival was extended from 14.5 months to 23.4 months in patients with epithelial subtype who underwent trimodality therapy.

What is Trimodality Therapy?

Trimodality is a type of multimodality that uses surgery, chemotherapy, and radiation therapy. According to the study it was the most effective type of multimodality therapy.

  • Surgery Icon


    Surgery is often the most effective tool against mesothelioma. There are two main types of pleural mesothelioma surgery: the extrapleural pneumonectomy (EPP) and pleurectomy with decortication (P/D). Both methods focus on removing as much of the tumor as possible.

    Treating patients with chemotherapy or radiation afterward can help kill any remaining cancer cells, preventing mesothelioma from returning.

  • Chemotherapy Icon


    Chemotherapy works by attacking cells that replicate quickly. Cancer cells multiply uncontrollably so they are targeted by chemotherapy. Chemotherapy is often given systemically, through an IV or a pill, and runs through the entire body.

    Some mesothelioma doctors also perform intraoperative chemotherapy, during which heated chemotherapy drugs are put in direct contact with the cancerous area during surgery.

  • Radiation Icon

    Radiation Therapy

    Radiation therapy is a noninvasive treatment that uses high energy beams to target tumors. Radiation oncologists will map out where the tumor is beforehand to make a plan to target it effectively with as little harm to healthy tissue as possible.

    This treatment is painless and is usually given in sessions that are under 30 minutes. Radiation can sometimes be given during surgery to give the beams direct contact to the cancer.

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    Sources & Author

  1. Long-Term Survival Outcomes of Cancer-Directed Surgery for Malignant Pleural Mesothelioma: Propensity Score Matching Analysis. Journal of Clinical Oncology. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/28817374. Accessed: 8/18/17.
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About the Writer, Jamie Iovino

Jamie Iovino is the senior writer at Mesothelioma Guide. She creates and edits pages to make sure mesothelioma patients and their families receive the newest and most accurate information about mesothelioma.