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Written By: Camryn Keeble

Peritoneal Mesothelioma Prognosis

A peritoneal mesothelioma prognosis comes after a doctor evaluates a patient's life expectancy based on their diagnosis and historical survival rates. Your prognosis depends on several factors, especially the stage of mesothelioma. This means each patient’s prognosis can be different.

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Important Facts About Peritoneal Mesothelioma Prognosis

  • Peritoneal mesothelioma forms in the lining of the abdomen (the peritoneum). Peritoneal mesothelioma is a rare cancer with an extremely long latency period (the time between exposure and cancer development). However, this type of mesothelioma does not spread as fast as pleural mesothelioma, and it often leads to a longer life expectancy.
  • The average prognosis for peritoneal mesothelioma patients is close to one year. If the patient undergoes surgery or other treatment, their prognosis often improves. Patients who have surgery typically have a prognosis of 3-5 years.
  • Several factors can affect a patient’s peritoneal mesothelioma prognosis, such as age, gender, lifestyle, diet and overall health. Improving on factors within the patient's control can lead to a better prognosis.

What Is a Peritoneal Mesothelioma Prognosis?

A peritoneal mesothelioma prognosis is the medical estimate of the cancer’s outcome. This estimate comes after the patient receives an official peritoneal mesothelioma diagnosis. Typically, a peritoneal mesothelioma prognosis is measured by the patient’s survival.

Peritoneal mesothelioma survival rates often impact a patient’s prognosis. Survival rates are a percentage that represents how many patients survive for a specific amount of time, For instance, the 2-year survival rate for peritoneal mesothelioma is 35%, meaning 35% of patients live for at least two years following their diagnosis. Mesothelioma specialists consider peritoneal mesothelioma survival rates when determining a prognosis.

A patient’s prognosis usually includes a life expectancy, as well as chances of remission (cancer shrinking) or recurrence (cancer returning after a period of time when cancer is not detected). It may also include predictions regarding quality of life, which is defined by your overall health (physical and mental), ability to enjoy life events, and overall comfort. When delivering a prognosis, your mesothelioma specialist will usually discuss changes you may experience in your physical health, the ability to remain active and ways to help maintain your quality of life. 

Patients may be given more than one prognosis throughout their peritoneal mesothelioma journey, especially if they undergo surgery or other treatments. A mesothelioma specialist may provide the patient with a prognosis associated with every available peritoneal mesothelioma treatment option. For instance, chemotherapy may offer patients a different life expectancy than peritoneal mesothelioma surgery.

Stage and Peritoneal Mesothelioma Prognosis

The stage of peritoneal mesothelioma cancer will affect the prognosis significantly. However, staging peritoneal mesothelioma does not follow the traditional four-stage system. Most specialists use the Peritoneal Cancer Index (PCI) to stage this disease.

The PCI splits the abdominal cavity into 13 regions. Each region receives a score of 0-3 based on the volume of peritoneal mesothelioma tumors in the region. The scores are then added up for a total score of 1-39. The higher the score, the more advanced the cancer. 

Early Stage Peritoneal Mesothelioma 

Early stage (PCI of 1-20) peritoneal mesothelioma patients usually have the best prognosis. Patients with lower PCI scores are eligible for more treatment options. For example, the 5-year survival rate for stage 1 (PCI of 1-10) peritoneal mesothelioma is 87%.

Late-Stage Peritoneal Mesothelioma 

Late-stage (PCI 21-39) peritoneal mesothelioma patients have a lower  life expectancy than patients diagnosed in early stages. A patient’s prognosis depends on many factors, including overall health, treatment eligibility and stage of cancer. Patients ineligible for treatment may have a life expectancy of up to one year.

Unfortunately, most mesothelioma patients – regardless of the type – are diagnosed in late stages. This occurs because the cancer can hide in the abdominal lining for decades before the patient experiences severe symptoms. Patients may also associate mesothelioma symptoms with more common conditions. 

By the time the patient attends a doctor’s appointment, shares their concerns, and gets a biopsy, the patient’s mesothelioma often has spread through the abdominal cavity. However, peritoneal mesothelioma tumors do not spread as quickly as pleural mesothelioma, so even late-stage peritoneal mesothelioma patients may have a hopeful prognosis.

What Factors Affect a Peritoneal Mesothelioma Prognosis?

Each prognosis is unique to the patient and their diagnosis. Doctors consider several factors when providing a peritoneal mesothelioma prognosis: 

  • Age and gender
  • Mesothelioma cell type 
  • Stage of mesothelioma
  • Treatment options 
  • Lifestyle and diet 
  • Survival rates          

Age and Gender

Younger patients often have a more positive peritoneal mesothelioma life expectancy due to their overall health status. They are also more likely to have stronger physical health, which makes them more suitable candidates for surgery. The average age of patients when diagnosed with peritoneal mesothelioma is 57.

Women with mesothelioma are also among the more positive prognosis group due to their likelihood to recognize and react to symptoms sooner, which often leads to an earlier diagnosis. Women are also known to be more consistent and committed to receiving treatment and attending doctor appointments. Around 40% of people diagnosed with peritoneal mesothelioma are women.

Mesothelioma Cell Type 

There are three mesothelioma cell types, and each has a different effect on the patient’s prognosis:

  • Epithelioid cells usually offer the most hopeful prognosis, as they are easier to identify and remove during surgery. This cell type accounts for the majority of all mesothelioma cases. One study reported epithelioid peritoneal mesothelioma patients had a median survival of 55 months.  
  • Sarcomatoid cells are the rarest type and usually lead to the worst prognosis. These cell types grow much faster than epithelioid cells, making it difficult to treat. Sarcomatoid peritoneal mesothelioma is extremely rare with an average prognosis of 13 months.
  • Biphasic cells are a mixture of epithelioid and sarcomatoid cells. The patient’s prognosis depends on which cell type their body has the most of. More epithelioid cells will lead to a more treatable cancer, while more sarcomatoid cells will be more difficult to treat.

Treatment Options

Peritoneal mesothelioma treatment options also affect life expectancy for patients. Each treatment option can have various effects on the patient and their cancer. 

Peritoneal Mesothelioma Surgery 

Peritoneal mesothelioma surgery usually offers patients the best chance at survival. However, not all patients are eligible for surgery. 

The primary surgery option for peritoneal mesothelioma patients is cytoreductive surgery with heated intraperitoneal chemotherapy (HIPEC). Cytoreductive surgery involves the surgical removal of mesothelioma tumors from the body. Surgeons focus on “debulking” the cancer by focusing on and removing all visible tumors. Doctors will then administer HIPEC, an intraoperative procedure that sends heated chemotherapy drugs directly into the abdomen, targeting remaining peritoneal mesothelioma tumors and cells. 

Peritoneal Mesothelioma Therapies

Peritoneal mesothelioma chemotherapy is a common treatment for patients. There are a few chemotherapy options for peritoneal mesothelioma patients: systemic chemotherapy, hyperthermic intraperitoneal chemotherapy (HIPEC), dwell chemotherapy and normothermic intraperitoneal chemotherapy (NIPEC). 

Immunotherapy is being tested in clinical trials for peritoneal mesothelioma. It has the potential to greatly improve a patient’s prognosis. In one study, the immunotherapy drug Keytruda led to an average survival of 20 months for peritoneal mesothelioma patients.

Lifestyle and Diet 

Lifestyle and diet can affect a patient’s life expectancy. Patients who regularly exercise and eat a nutritious diet can have a more positive prognosis due to their overall health.

How to Improve Prognosis for Peritoneal Mesothelioma

There are several factors affecting a patient’s prognosis. By becoming more knowledgeable about your diagnosis and treatment options, you can improve your prognosis. There are many ways to extend your life expectancy. 

Evaluate Your Treatment Options

Mesothelioma treatment options may seem limited, but research and development continues to make progress for the benefit of mesothelioma patients.

Surgery may be the most favorable treatment option to extend a patient’s life expectancy, but not all patients are eligible for surgery. They will need other treatment options, such as chemotherapy or immunotherapy. Many clinical trials also focus on peritoneal mesothelioma. Participating in clinical trials can get the patient the chance to improve their prognosis and even lead to advancements in mesothelioma treatment.

Connect With an Experienced Mesothelioma Specialist

Being evaluated by an experienced mesothelioma specialist is one of the most important things to do when you are diagnosed with peritoneal mesothelioma. Connecting with a mesothelioma specialist will ensure you have an accurate diagnosis, access to all treatment options, and a better chance of improving your prognosis.

Mesothelioma specialists have worked for decades to better understand and treat this type of cancer. They are experts on this cancer and will provide patients with superior care. Non-specialized doctors most likely do not have the experience to navigate such a complex disease.

Mesothelioma Guide can help you connect with a specialist for peritoneal mesothelioma at one of the top cancer centers in the world. University of Pittsburgh Medical Center (UPMC) is an example of a top cancer center with an experienced peritoneal mesothelioma treatment program.

Improve Your Overall Health

An overall healthy patient is usually more suitable for additional treatment options as their body can handle and recover from aggressive treatment methods, such as surgery. The healthier the patient, the stronger their immune system is, which means it can effectively combat cancer cells. 

Patients can improve their health at any time during their mesothelioma journey. Even if they weren’t at peak health when diagnosed, it’s never too late to improve. Patients have the best chance at treatment eligibility and response when their body is functioning at full strength. Maintaining a healthy sleep schedule, exercising regularly, and eating a nutritious diet are all ways to improve your health and your mesothelioma prognosis. 

Get a Second Opinion

Getting a second opinion after receiving a mesothelioma diagnosis is crucial. Peritoneal mesothelioma is challenging to diagnose and can often be misdiagnosed. The stage of peritoneal mesothelioma is important to know in order to determine the prognosis. A second opinion from a mesothelioma specialist may change the stage and treatment options and provide access to treatments that were unknown before.

Frequently Asked Questions About Peritoneal Mesothelioma Prognosis

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How Long Do People Live with Peritoneal Mesothelioma?

People with peritoneal mesothelioma typically live for 1-2 years but can live longer. There are instances of patients surviving for more than five years after their diagnosis. It depends on varying factors, including the stage of diagnosis, the patient’s overall health, and the treatment plan.

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What Is the Average Prognosis for Peritoneal Mesothelioma?

The average prognosis for peritoneal mesothelioma after a successful cytoreduction with HIPEC is 3-5 years. Peritoneal mesothelioma forms in the lining of the abdomen and does not spread as rapidly as pleural mesothelioma. The average peritoneal mesothelioma prognosis is longer than pleural mesothelioma.

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What Factors Can Affect Peritoneal Mesothelioma Prognosis?

There are several factors affecting a patient’s peritoneal mesothelioma prognosis, such as: 

  • Age and gender
  • Mesothelioma cell type
  • Treatment options
  • Survival rates
  • Stage of mesothelioma
  • Lifestyle and diet
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How Can I Improve My Peritoneal Mesothelioma Prognosis?

Improving your overall health can improve your peritoneal mesothelioma prognosis. Connecting with an experienced mesothelioma specialist is the best way to improve your prognosis. They have the most experience with this complex cancer and can offer the best care, as they have more knowledge on treatment and how mesothelioma affects the patient and their loved ones.

Sources & Author

    1. Peritoneal Mesothelioma. Cleveland Clinic. Retrieved from: https://my.clevelandclinic.org/health/diseases/23973-peritoneal-mesothelioma#outlook–prognosis. Accessed: 03/21/2023.
    2. Life Expectancy in Pleural Peritoneal Mesothelioma. National Library of Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292397/. Accessed: 03/21/2023.
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About the Writer, Camryn Keeble

Camryn Keeble is the senior content writer and editor for Mesothelioma Guide. She creates informative content to educate mesothelioma patients and their loved ones on news, treatments and more. She also works diligently to raise awareness of the dangers of asbestos exposure and the effects of mesothelioma.