Written By: Devin Golden

Epithelioid Mesothelioma Prognosis

When people are diagnosed with mesothelioma, they are usually told the type of mesothelioma they have, the cell type and their prognosis. Epithelioid mesothelioma is one of the cell types of this cancer, and the prognosis for epithelioid mesothelioma is typically better than the other two cell types: sarcomatoid and biphasic.

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 Epithelioid Mesothelioma Prognosis

  • A prognosis is given to patients by their doctor. The prognosis for mesothelioma is based on a few factors, including the cell type.
  • Epithelioid mesothelioma has the best prognosis because of how the cells appear and spread. Epithelioid mesothelioma tumors are easier to remove during surgery than the other cell types.
  • A prognosis is not an exact determination of your life expectancy. Many patients far outlive their prognosis due to lifestyle changes, successful treatments, and more factors.

What Is a Prognosis for Cancer?

A prognosis for cancer is a medical forecast of how the disease will progress and a timeline for how quickly the cancer will spread. Part of a cancer prognosis includes a medical forecast of the outcome, including the length of survival.

This forecast is not an exact science and is merely used to set patient expectations. A prognosis for a specific type of cancer is usually based on data from past cases with similar characteristics: stage, age, overall health and treatment plan.

What Is the Usual Prognosis for Epithelioid Mesothelioma?

The prognosis for epithelioid mesothelioma ranges from 10-20 months. Epithelioid mesothelioma has the best average prognosis of the three cell types. According to the Orphanet Journal of Rare Diseases, most patients who survive for two years after their diagnosis have epithelioid mesothelioma.

Fortunately, epithelioid mesothelioma is the most common cell type. People with mesothelioma receive an epithelioid mesothelioma diagnosis in up to 70% of cases.

Epithelioid mesothelioma has the best prognosis because it’s the easiest to treat with surgery. Epithelioid mesothelioma cells are well-defined and easily identifiable in tests of tissue samples. They have well-defined nuclei, pink cytoplasm, and elongated egg shape. They also don’t metastasize as quickly as other cell types.

Most patients have epithelioid pleural mesothelioma, which means the cancer forms in the lining of the lungs (pleura). The other common place epithelioid mesothelioma forms is in the lining of the abdominal cavity (peritoneum). The prognosis is usually better for patients with epithelioid peritoneal mesothelioma than for patients with epithelioid pleural mesothelioma.

Survival Rates for Epithelioid Mesothelioma

Epithelioid mesothelioma usually has the best survival rate because it responds to treatment better, spreads slowly, and tumors are easily detectable on scans and during surgery.

Survival rates for epithelioid mesothelioma can significantly improve with successful surgery. One study found that epithelioid pleural mesothelioma patients’ survival improved from 20-25 months due to successful mesothelioma surgery

Immunotherapy for epithelioid pleural mesothelioma has had a positive impact. Opdivo and Yervoy, two FDA-approved immunotherapies for mesothelioma, led to an average survival of 19 months for patients with epithelioid pleural mesothelioma who couldn’t have surgery. This length is 3-5 months longer than the average for patients who receive just chemotherapy.

Survival Rates by Type of Mesothelioma

The most significant factor for prognosis is where the patient’s mesothelioma forms. There are three types of mesothelioma: 

The average prognosis is better for epithelioid peritoneal mesothelioma than for epithelioid pleural mesothelioma:

  • According to a study published on UpToDale, epithelioid pleural mesothelioma patients survive for an average of 19 months.
  • According to a different study, epithelioid peritoneal mesothelioma patients survived for an average of 55 months.

There is not enough data about epithelioid pericardial mesothelioma, as this type of mesothelioma is very rare. Less than 1% of people with mesothelioma have pericardial mesothelioma.

Other Factors Affecting an Epithelioid Mesothelioma Prognosis

There are a few factors affecting a prognosis for epithelioid mesothelioma. The main factors are:

  • Stage of the mesothelioma
  • Treatment options available to the patient
  • Age and overall health of the patient


The stage of mesothelioma has a huge impact on the prognosis for a patient with this cancer and cell type.

Stage 1 is the earliest of the four stages of mesothelioma and has the best prognosis. Patients diagnosed in this stage usually live for around two years after the diagnosis.

Stage 4 is the most advanced stage. Patients diagnosed in this stage usually live for 8-10 months after the diagnosis.


Epithelioid mesothelioma treatment also affects the prognosis because some treatment options lead to longer survival. For instance, patients who have a successful surgery usually live for 2-3 years after the operation. Patients who undergo chemotherapy or immunotherapy, without surgery, live for 14-18 months.

Part of an epithelioid mesothelioma prognosis is the patient’s quality of life while living with the cancer. This includes recovering from surgery or any potential long-term complications from surgery. For instance, one surgery for mesothelioma (extrapleural pneumonectomy surgery) removes one of the lungs. This can impact a patient’s breathing and exercise tolerance.

Age and Health

If the patient is in poor health, then their prognosis usually worsens. The overall health of the patient can limit the treatment options for the patient. Age is not always a factor, but it’s sometimes tied to health. A lot of older patients are not healthy enough to undergo surgery or tolerate chemotherapy.

Frequently Asked Questions About Epithelioid Mesothelioma Prognosis

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What is the Usual Prognosis for Epithelioid Mesothelioma?

Your prognosis for epithelioid mesothelioma cancer depends on a few factors, such as your age, health, the stage of your mesothelioma, and your treatment options. A major factor is where the cancer forms. If it forms in the pleura (lining of the lungs), then the prognosis will be different than if it forms in the peritoneum (lining of the abdominal cavity).

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What Is the Average Survival for Epithelioid Mesothelioma?

The average survival for mesothelioma is 1-2 years. Epithelioid mesothelioma has the best prognosis of the three cell types (the other two are sarcomatoid mesothelioma and biphasic mesothelioma). The average survival for epithelioid pleural mesothelioma, according to one study, is 19 months.

Sources & Author

  1. Presentation, initial evaluation, and prognosis of malignant pleural mesothelioma. UpToDate. Retrieved from: https://www.uptodate.com/contents/presentation-initial-evaluation-and-prognosis-of-malignant-pleural-mesothelioma?topicRef=4625&source=see_link. Accessed: 04/17/19.
  2. Malignant peritoneal mesothelioma: Epidemiology, risk factors, clinical presentation, diagnosis, and staging. UpToDate. Retrieved from: https://www.uptodate.com/contents/malignant-peritoneal-mesothelioma-epidemiology-risk-factors-clinical-presentation-diagnosis-and-staging. Accessed: 12/16/19.
  3. Malignant mesothelioma. Orphanet Journal of Rare Diseases. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652430/. Accessed: 10/04/19.
    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.