Written By: Camryn Keeble

Pleural Mesothelioma Survival Rates

Pleural mesothelioma survival rate is the percentage of people with pleural mesothelioma who live for a certain amount of time. Doctors rely on survival rates for pleural mesothelioma to determine a prognosis for patients. Due to advanced research and the development of new treatments, the survival rates for pleural mesothelioma are improving.

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse


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Important Facts About Pleural Mesothelioma Survival Rates

  • Pleural mesothelioma survival rates can improve. The 1-year survival rate is close to 50%, but it decreases significantly with each additional year of survival.
  • Patients diagnosed with pleural mesothelioma in early stages have the best chance for long-term survival as the cancer has not grown or spread significantly.
  • There are several factors contributing to a patient’s survival rate, such as age, cell type, gender, stage and treatment.

What Is a Survival Rate?

Survival rate refers to the percentage of patients diagnosed with a serious illness who reach a specific survival milestone. The rate is typically measured in increments of years, such as the 1-year, 2-year, or 5-year survival rate and so on. 

Measuring the survival rate starts when the patient is diagnosed or after a specific treatment is completed, and it ends when the patient passes away from their illness. Doctors can use the survival rate to help determine a prognosis by comparing similar cases and how the disease affected the patient. 

The survival rate is based on past cases, which means a survival rate prediction may not apply to a current or future patient. For instance, a pleural mesothelioma survival rate is a benchmark doctors use to determine a course of action, as well as provide the patient with a pleural mesothelioma prognosis

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A survival rate can be broken down into age groups, gender, type of disease, treatment plan and more. By dividing survival rate data into specific groups, doctors can provide a more relevant prediction for each individual case.

What Are the Rates for Pleural Mesothelioma? Icon

What Are the Rates for Pleural Mesothelioma?

Unfortunately, overall survival rates for pleural mesothelioma are lower than for most other cancers. The 1-year survival rate for pleural mesothelioma is close to 50%.

The survival rates significantly decrease as time goes on. For instance, the 2-year survival rate for pleural mesothelioma is 18%, and the 5-year survival rate is 12%. However, survival rates heavily depend on the cancer stage at the time of diagnosis and a patient’s pleural mesothelioma treatment options.

Early Stage Pleural Mesothelioma Survival Rates

The survival rate for early stage pleural mesothelioma patients is higher than the other three stages, and it is highly dependent on the treatment plan. Survival rates for stage 1 pleural mesothelioma have been reported between 35% and 40%.

Pleural mesothelioma surgery is proven to have positive effects on survival. According to a study published in the Annals of Translational Medicine, around 59% of patients who underwent pleurectomy with decortication (P/D) survived for two years. Extrapleural pneumonectomy (EPP) did not have as strong of an effect on survival, but it was still helpful. Nearly 39% of EPP patients survived for two years.

P/D Two-Year Survival Rate Pie Chart

P/D Two-Year Survival Rate

EPP Two-Year Survival Rate Pie Chart

EPP Two-Year Survival Rate

Patients with a stage 2 pleural mesothelioma typically have a promising life expectancy. If they have a successful surgery, their life expectancy improves.

According to a study published in the Journal of Thoracic Disease, close to 70% of stage 1 and stage 2 pleural mesothelioma patients lived for two years following pleural mesothelioma surgery and radiation therapy. This rate was significantly more than the 35% 2-year survival rate for patients who only had surgery.

Surgery w/ Radiation Pie Chart

Surgery w/ Radiation

Surgery w/o radiation Pie Chart

Surgery w/o radiation

Late-Stage Pleural Mesothelioma

Survival rates for late-stage pleural mesothelioma depend on various factors, primarily whether or not the patient is eligible for surgery. Stage 3 pleural mesothelioma is the most common mesothelioma diagnosis, but not every patient is eligible for surgery.

The 2-year survival rate for stage 3 pleural mesothelioma is approximately 40% for patients undergoing pleurectomy with decortication (P/D). Many studies compare EPP and P/D for stage 3 pleural mesothelioma cases. One study shows close to 37% of patients who had an extended P/D survived for at least three years, while 23% of patients who had an EPP survived for the same amount of time.

P/D Three-Year Survival Rate Pie Chart

P/D Three-Year Survival Rate

EPP Three-Year Survival Rate Pie Chart

EPP Three-Year Survival Rate

Stage 4 pleural mesothelioma patients have a poor prognosis compared to patients in earlier stages. According to a study published in the American Journal of Thoracic Oncology, the 2-year survival rate for stage 4 pleural mesothelioma patients is 20%.

Factors Affecting Pleural Mesothelioma Survival Rates

There are a few factors affecting pleural mesothelioma survival rates. Other than age, gender, health and treatment plan, there are medical factors that should be considered when evaluating pleural mesothelioma life expectancy. 

Stage of Pleural Mesothelioma Icon

Stage of Pleural Mesothelioma

Survival rates change depending on the patient’s stage of pleural mesothelioma at the time of diagnosis, due to the strong correlation between stage and life expectancy. Patients diagnosed in early stages (stage 1 or 2) typically have better survival rates. Patients diagnosed in late stages (stage 3 or 4) tend to have lower survival rates, as the cancer is more advanced and more challenging to treat.

Pleural mesothelioma patients age 65 or older have five times better survival rates at stage 1 than at stage 4.

Mesothelioma is most often diagnosed in later stages (stage 3 or 4) due to the long latency period of the cancer and the aggressive nature of the disease.

Mesothelioma Cell Type Icon

Mesothelioma Cell Type

All mesothelioma cases, including pleural mesothelioma, are diagnosed with a specific cell type: epithelioid, sarcomatoid or biphasic. Mesothelioma cell type plays an important role in determining the patient’s survival rate.

Epithelioid mesothelioma often has the most hopeful survival rate. Epithelioid cells have the best response to treatment. They spread slower than the other two types and are easier to identify on imaging scans or during surgery. The sarcomatoid cell type has the lowest survival rate. They spread quickly and are difficult to locate and treat.

Survival rates for each mesothelioma cell type can vary:

  • Epithelioid mesothelioma has a 1-year survival rate over 50% and a 2-year survival rate slightly below 50%.
  • Sarcomatoid mesothelioma has a 1-year survival rate well below 50%.
  • Biphasic mesothelioma is a combination of both epithelioid and sarcomatoid cells. The ratio of the epithelioid and sarcomatoid cells can affect survival, as patients with more epithelioid cells have a better chance of a positive outcome.
Treatments: Surgery & Immunotherapy Icon

Treatments: Surgery & Immunotherapy

Pleural mesothelioma survival rates can improve significantly based on the treatment options available to the patient. The most common treatment options that help improve survival are pleural mesothelioma surgery and pleural mesothelioma immunotherapy.

Pleural Mesothelioma Surgery

Pleural mesothelioma surgery offers the patient the best chance of improved survival because surgery can remove most or all of the tumors. By removing the mesothelioma tumors and cancer cells, the body has less disease to fight off, and there’s less chance of the cancer growing or spreading.

According to studies, pleural mesothelioma surgery options have greatly improved survival rates:

Improved Survival Rates with EPP Bar Chart

Improved Survival Rates with EPP

Improved Survival Rates with PD Bar Chart

Improved Survival Rates with PD

2-year Survival Rate

5-year Survival Rate

Pleural Mesothelioma Immunotherapy

Pleural mesothelioma immunotherapy is another treatment option proven to increase survival for pleural mesothelioma patients, especially compared to patients who receive only chemotherapy or radiation. Opdivo and Yervoy, the two FDA-approved immunotherapy drugs for pleural mesothelioma, are prescribed as a combination therapy.

The 2-year survival rate for patients taking Opdivo and Yervoy is close to 40%. The 3-year survival rate is 23%.

Survival Rates with Immunotherapy Bar Chart

Survival Rates with Immunotherapy

2-year Survival Rate

3-year Survival Rate

Frequently Asked Questions About Pleural Mesothelioma Survival Rates

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How Long Can You Live with Pleural Mesothelioma?

There are several factors affecting a mesothelioma patient’s survival. The most important factors are the stage of diagnosis and the treatment plan. Patients diagnosed in early stages (stage 1 or 2) have the best survival rate.

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What Is the Survival Rate for Pleural Mesothelioma?

The 1-year survival rate for pleural mesothelioma is between 40%-50%. The rate decreases with each additional year of survival. The 2-year survival rate is 18%, and the 5-year survival rate is 12%.

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What Factors Can Affect Pleural Mesothelioma Survival Rate?

There are several factors affecting a pleural mesothelioma patient’s survival:

    • Age
    • Cell Type
    • Gender
    • Stage
    • Treatment

Sources & Author

  1. Survival Rates for Mesothelioma. American Cancer Society. Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/survival-statistics.html. Accessed: 01/01/2023.
  2. Preoperative immunotherapy for mesothelioma shows favorable outcomes. Baylor College of Medicine. Retrieved from: https://www.bcm.edu/news/preoperative-immunotherapy-for-mesothelioma-shows-favorable-outcomes. Accessed: 12/14/2022.
  3. Opdivo (nivolumab) Plus Yervoy (ipilimumab) Demonstrates Durable Overall Survival at Three Years Compared to Chemotherapy in First-Line Unresectable Malignant Pleural Mesothelioma in Phase 3 CheckMate -743 Trial. BusinessWire. Retrieved from: https://www.businesswire.com/news/home/20210913005059/en/Opdivo-nivolumab-Plus-Yervoy-ipilimumab-Demonstrates-Durable-Overall-Survival-at-Three-Years-Compared-to-Chemotherapy-in-First-Line-Unresectable-Malignant-Pleural-Mesothelioma-in-Phase-3-CheckMate–743-Trial. Accessed: 09/14/2021.
  4. Pleurectomy/decortication and hyperthermic intrathoracic chemoperfusion using cisplatin and doxorubicin for malignant pleural mesothelioma. Journal of Thoracic Disease. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588772/. Accessed: 01/22/2021.
  5. A Phase III Randomized Trial of Pleurectomy/Decortication Plus Chemotherapy With or Without Adjuvant Hemithoracic Intensity-Modulated Pleural Radiation Therapy (IMPRINT) for Malignant Pleural Mesothelioma (MPM) (NRG LU-006). International Journal of Radiation Oncology. Retrieved from: https://www.redjournal.org/article/S0360-3016(21)02168-4/fulltext#relatedArticles. Accessed: 10/31/2021.
  6. Hyperthermic intrathoracic chemotherapy (HITHOC) should be included in the guidelines for malignant pleural mesothelioma. Annals of Translational Medicine. Retrieved from: https://atm.amegroups.com/article/view/60185/pdf. Accessed: 01/26/2021.
  7. Systematic Review and Meta-Analysis of Pleurectomy/Decortication versus Extrapleural Pneumonectomy in the Treatment of Malignant Pleural Mesothelioma. Journal of Clinical Medicine. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/36233416/. Accessed: 10/18/2022.
  8. Predictors and Outcomes of Surgery in Peritoneal Mesothelioma: An Analysis of 2000 Patients From the National Cancer Database. Annals of Surgical Oncology. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/32006127/. Accessed: 07/08/2020.
  9. A pilot trial of high-dose-rate intraoperative radiation therapy for malignant pleural mesothelioma. American Brachytherapy Society. Retrieved from: https://www.brachyjournal.com/article/S1538-4721(04)00213-2/abstract. Accessed: 01/22/2021.
  10. 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.
  11. Malignant Mesothelioma. National Cancer Institute. Retrieved from: https://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq. Accessed: 10/15/18.
  12. Malignant Mesothelioma Mortality. Centers for Disease Control and NIOSH. Retrieved from: https://wwwn.cdc.gov/eworld/Data/Malignant_mesothelioma_all_sites_Number_of_deaths_crude_and_age-adjusted_death_rates_US_residents_age_15_and_over_19992014/921. Accessed: 10/15/18.
  13. An Investigation of Cancer-Directed Surgery for Different Histologic Subtypes of Malignant Pleural Mesothelioma. National Library of Medicine. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/36574925/. Accessed: 01/03/2023.
  14. Life Expectancy in Pleural and Peritoneal Mesothelioma. Lung Cancer International. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292397/. Accessed: 04/09/2020.
  15. A novel tumor‐node‐metastasis (TNM) staging system of diffuse malignant peritoneal mesothelioma using outcome analysis of a multi‐institutional database. American Cancer Society Journals. Retrieved from: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.25640. Accessed: 04/14/2020.
  16. Initial Analysis of the International Association For the Study of Lung Cancer Mesothelioma Database. Journal of Thoracic Oncology. Retrieved from: https://www.jto.org/article/S1556-0864(15)33132-4/fulltext. Accessed: 04/14/2020.
  17. Extrapleural pneumonectomy (EPP) vs. pleurectomy decortication (P/D). Annals of Translational Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497106/table/t5/. Accessed: 04/14/2020.
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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.