Sarcomatoid Mesothelioma Prognosis

What Is a Prognosis for Mesothelioma?

A prognosis for mesothelioma is a medical prediction of the cancer’s outcome. When specialists provide a mesothelioma prognosis, they will give insight into how they expect the cancer will progress and how fast it will spread.

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

What Is the Usual Prognosis for Sarcomatoid Mesothelioma?

Sarcomatoid mesothelioma has the worst outcome and survival rate of the other mesothelioma cell types. The average prognosis for sarcomatoid mesothelioma ranges from 5-13 months, depending on the treatments used, whether it’s peritoneal or pleural mesothelioma and the patient’s overall health at the time of diagnosis. 

According to a study published in Clinical Lung Cancer, the median survival rate for sarcomatoid mesothelioma patients who do not undergo treatment is less than six months. However, if the disease is diagnosed at an early stage, and the patient meets the surgical and treatment criteria, then their postoperative life expectancy increases to an average of 11.2 months.

There have been studies conducted to analyze the average survival for patients with sarcomatoid mesothelioma, and the results are rather consistent. One study reports a median survival of 6 months for sarcomatoid mesothelioma patients, while another reports a survival of 5.8 months. Two other studies report median survival for sarcomatoid mesothelioma as 5.5 months and 5.3 months. 

Sarcomatoid mesothelioma is the least common cell type. Only 20% of all mesothelioma cases result in a sarcomatoid mesothelioma diagnosis. 

Sarcomatoid mesothelioma has a poor prognosis due to the aggressive and unpredictable nature of this cell type. Sarcomatoid mesothelioma cells have an abnormal appearance and are often difficult to differentiate from healthy tissue. They also grow and spread quicker than other cell types.

Sarcomatoid cells are long, narrow and shaped like ovals. They also have enlarged, elongated nuclei and could even have more than one nucleus. These cells can also have a different appearance from one another, which makes them unpredictable and difficult to remove.

Survival Rates for Sarcomatoid Mesothelioma

Sarcomatoid mesothelioma usually has a poor survival rate because it does not respond well to treatment, spreads aggressively, and tumors are difficult to detect or identify.

Survival rates for sarcomatoid mesothelioma can significantly improve with successful treatment or therapy. According to a study published in the National Library of Medicine, sarcomatoid mesothelioma responds positively to immunotherapy treatments, specifically with the combination of nivolumab (Opdivo) and ipilimumab (Yervoy).

The results showed:

• The average survival was 18.1 months with immunotherapy (Opdivo and Yervoy) compared to 14.1 months with chemotherapy treatment.
• The 2-year survival rate was 41% with immunotherapy and 27% with chemotherapy.

Survival Rates by Type of Mesothelioma

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

• Pleural mesothelioma forms in the pleura, which is the lining of the lungs.
• Peritoneal mesothelioma forms in the peritoneum, which is the lining of the abdominal cavity.
• Pericardial mesothelioma forms in the pericardium, which is a sac around the heart.

Most patients with the sarcomatoid cell type have pleural mesothelioma, which means the cancer forms in the lining of the lungs (pleura). The other type of sarcomatoid mesothelioma forms in the lining of the abdomen (peritoneum). The prognosis is usually more positive for patients with sarcomatoid peritoneal mesothelioma than for patients with sarcomatoid pleural mesothelioma.

According to one study:

• Sarcomatoid pleural mesothelioma patients survived for an average of 8 months.
• Sarcomatoid peritoneal mesothelioma patients survived for approximately 13 months on average.

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

Other Factors Affecting a Sarcomatoid Mesothelioma Prognosis

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

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

Stage

The stage of sarcomatoid mesothelioma has a huge impact on the prognosis for a patient. Stage 1 is the earliest of the four mesothelioma stages and has the most promising prognosis, although the prognosis is still poor for sarcomatoid mesothelioma. However, early detection of any cancer type can improve a patient’s prognosis because the cancer cells have likely not yet spread or grown significantly.

Stage 4 is the most advanced stage of mesothelioma. Patients diagnosed in this stage usually have a poor prognosis due to the rapid and aggressive growth of this mesothelioma cell type.

Treatment

Sarcomatoid mesothelioma treatment options can significantly affect the patient’s prognosis as treatment options typically improve survival. There are often limited treatment options for sarcomatoid mesothelioma patients due to the rarity and aggressive nature of this cell type.

In most mesothelioma cases, surgery is a primary treatment option. However, sarcomatoid cells can be challenging to identify and remove, so specialists often recommend chemotherapy, immunotherapy, clinical trials, other emerging treatment options or palliative therapies.

A contributing factor to a sarcomatoid mesothelioma prognosis is quality of life. This includes side effects from treatments, recovering from surgery or any potential long-term complications from surgery.

Age and Health

A patient’s advanced age and poor health before a mesothelioma diagnosis can negatively impact their prognosis. The overall health of a patient can expand or limit the treatment options available. Age is not always a factor, but it is sometimes linked to overall health. Many older patients are not healthy enough to undergo surgery or tolerate chemotherapy.