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What Is a Survival Rate?
Survival rate is the percentage of patients who reach a specific survival benchmark with a deadly disease. It’s usually measured in increments of every six months or one year. For instance, there is a 1-year survival rate, 2-year survival rate, 3-year survival rate and 5-year survival rate.
The measurement begins either once the patient is diagnosed or after a specific treatment. It ends when the patient passes away. Doctors then calculate the survival rate based on many cases.
The survival rate is based on past cases. Therefore, it’s not a prediction of survival for a current or future case. It’s a benchmark for doctors and patients to make decisions regarding treatment or what to expect with life expectancy.
Survival rate can be broken down into age groups, gender, type, treatment and more. This gives a more accurate prediction for each individual case. The survival rates are used to give patients their mesothelioma prognosis, but many patients do better than their prognosis.
What Is the Survival Rate for Mesothelioma?
Unfortunately, the survival rate for mesothelioma is poor. The 1-year survival rate of pleural mesothelioma is around 50%. Peritoneal mesothelioma has a similar 1-year percentage.
The survival rates for peritoneal mesothelioma are higher. For instance, the 2-year rate is 35%. There are instances where people with pleural mesothelioma survive for longer than people with peritoneal mesothelioma.
The survival rates increase dramatically after successful surgery intervention. It improves incrementally for other therapies, such as chemotherapy, immunotherapy and tumor treating fields.
Why Survival Rates Don’t Tell the Whole Story
Survival rates don’t tell the whole story. It can be discouraging to learn about the survival rates when you or a loved one has mesothelioma cancer, these rates should not cause you to lose hope.
There are a few ways that mesothelioma survival rates can be misleading. Here are three reasons not to put too much stock in the reported mesothelioma survival rates; survival rates continue to improve, new treatment options becoming available, and the context is misleading.
Survival Data Continues to Improve
Survival rates don’t always reflect current data. Survival rates are based on historical data. Doctors examine the results of people treated in the past in order to provide this data. They only offer a glimpse into the past, not the future.
New Treatment Options
Survival rates do not account for new mesothelioma treatment options, like immunotherapy or cell and gene therapy, or advances in techniques for existing treatments, such as surgery. Many of these treatments were not available at the time the data was collected.
Treatment options for cancers like mesothelioma have been developing quickly through clinical trials in the past decade. For instance, immunotherapy outperforms chemotherapy in survival by four months. The 1-year and 2-year rates are also better for immunotherapy.
Context Is Missing
General survival averages can be misleading because they include patients who didn’t receive treatment. They also include patients with poor health, in their 70s or 80s in age, treated by general oncologists rather than mesothelioma specialists, and other inhibiting factors.
For example, patients who are diagnosed before the age of 65 live an average of three months longer than those diagnosed between the ages of 65 and 74.
Patients and families should remember that all statistics have a degree of error. Your chances of survival improve when you are in better health, go to a mesothelioma specialist at a top cancer center, and receive recommended treatment like surgery or immunotherapy.
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Including Cell Type
Factors Affecting Mesothelioma Survival Rates
A few other factors – aside from age, gender, health and not receiving treatment – affect the survival rates for mesothelioma. These are what to consider when looking at mesothelioma survival percentages and assessing your life expectancy.
Location of Tumors
A study by the National Cancer Institute found that peritoneal mesothelioma has a better long-term survival average. Around 35% peritoneal mesothelioma patients survive for two years while only 18% of pleural mesothelioma cases survive that long. The 5-year survival rate is 18% for peritoneal mesothelioma and 5% for pleural mesothelioma.
These numbers show treatment for peritoneal mesothelioma is more effective than treatment for pleural mesothelioma. Peritoneal mesothelioma is also easier to treat with surgery – a higher percentage of patients are eligible for surgery – because pleural mesothelioma invades the chest cavity impacting the lungs and heart, giving a narrow window when surgery is possible.
Stage of Mesothelioma
Survival percentages change for each of the four stages of mesothelioma. There is a strong correlation between mesothelioma stage and life expectancy. Patients diagnosed at the early stages (with less metastasis) have significantly better survival rates.
At age 65 or older, mesothelioma patients have five times better survival rates at stage 1 than at stage 4.
Mesothelioma is often diagnosed in the later stages because of the lack of obvious symptoms. Survival rates in stages 3 and 4 are lower because the cancer is more advanced and more difficult to treat.
Here are estimated survival rates for the four stages of mesothelioma:
- Stage 1 is close to a 50% 2-year survival rate.
- Stage 2 has a 2-year survival rate of 35%-40%.
- Stage 3 has a 2-year survival rate of around 25%.
- Stage 4 has a 2-year survival rate under 20%.
Mesothelioma Cell Type
Any case of mesothelioma is diagnosed as one of three cell types: epithelioid, sarcomatoid or biphasic. Cell type is an important factor in survival. Epithelioid mesothelioma typically has the best survival rate because it reacts better to treatment, spreads slower, and is easier to find tumors on scans and during surgery. The sarcomatoid cell type has the lowest rate due to it spreading quickly, being more difficult to locate and more difficult to treat.
Here is a snapshot of survival rates for the mesothelioma cell types:
- Epithelioid mesothelioma has a 1-year survival rate over 50% and a 2-year survival rate just under 50%.
- Sarcomatoid mesothelioma has a 1-year survival rate well below 50%. The 3-year survival rate is reportedly close to 0%.
- Biphasic mesothelioma is a combination of epithelioid and sarcomatoid cells. Survival statistics for biphasic cell types are not consistent. The ratio of epithelioid cells to sarcomatoid cells can affect survival. Patients with a higher percentage of epithelioid cells have a better overall outcome.
Surgery can improve survival for mesothelioma patients. A recent study found that epithelioid mesothelioma patients’ survival improved from 20 months to 25 months thanks to surgery. Sarcomatoid and biphasic cases did not show an increased improvement after surgery.
Each cell type is unique, which is why patients should find a mesothelioma specialist to treat them. Mesothelioma specialists can offer specialized expertise to their patients.
Treatments: Surgery & Immunotherapy
Mesothelioma survival can be greatly improved when patients have surgery. This is because surgery for mesothelioma removes most of the visible tumors, decreasing the disease volume.
By decreasing the amount of cancer cells and tumors means the body has less to fight and the fewer chances of metastasis. This may not cure the disease, but it may grant the patient more time before the disease starts to grow and spread.
According to studies, these three mesothelioma surgeries have greatly increased survival rates:
- Extrapleural pneumonectomy (pleural mesothelioma) – Led to a 2-year survival rate of 32%-41% and a 5-year survival rate of 14%
- Pleurectomy/decortication (pleural mesothelioma) – Caused a 2-year survival rate of 59% and 5-year survival rate of 20%-25%
- Cytoreductive surgery with HIPEC (peritoneal mesothelioma) – Wake Forest Baptist Cancer Center reported a 5-year survival rate of 30%
Immunotherapy has also proven to help improve the survival rates for mesothelioma patients. Opdivo and Yervoy, the two FDA-approved immunotherapy drugs for pleural mesothelioma, are given as a combination drug therapy. The 2-year survival rate is around 40% and a 3-year survival rate of 23%.
In one study testing immunotherapy versus chemotherapy, the 1-year survival rate for immunotherapy patients was 76%.
Beating the Odds: Improve Your Mesothelioma Survival
Survival rates give patients an approximation of how long people with a similar diagnosis have lived. They are based on a range of factors from tumor location to the patient’s age. These statistics may give patients a clearer picture of their diagnosis so they can develop a treatment plan best suited for them.
“I knew I was a fighter and could handle whatever happened,” said mesothelioma survivor Jodi Page
Due to the many factors that can impact a patient’s survival, it is important to take survival statistics lightly and to not be discouraged. Mesothelioma is an aggressive cancer but is also very unpredictable, many patients living beyond their original prognosis.
Survival rates are only a guideline. Learn more about beating the odds in our free Mesothelioma Guide book, which also comes with other free resources to inspire you to win the fight against mesothelioma cancer.
Common Questions About Mesothelioma Survival Rates
What is the survival rate for pleural mesothelioma?
The 1-year survival percentage is 40%-50% for pleural mesothelioma. The rate decreases with each additional year, although some patients provide examples of long-term survival:
- The 2-year survival rate is 18%.
- The 5-year survival rate is 5%.
What is the survival rate for peritoneal mesothelioma?
The 1-year survival percentage for peritoneal mesothelioma is 50%. Peritoneal mesothelioma typically has a better prognosis than pleural mesothelioma. The survival rate decreases with each year, but patients have hope for long-term survival:
- The 2-year survival rate is 35%.
- The 5-year survival rate is 18%.
Why is the mesothelioma survival rate improving?
Mesothelioma survival is improving due to heightened awareness of symptoms, more doctors with experience recognizing this rare cancer, and promising new therapies. These aspects are also the driving forces behind boosts in survival rates:
- Improved surgical techniques and experience from specialists.
- Immunotherapy and tumor treating fields are options for non-surgical candidates.
What factors can affect survival rates for mesothelioma?
The location of mesothelioma has arguably the biggest effect on survival. Peritoneal mesothelioma usually has better long-term survival chances than pleural mesothelioma. Other significant factors include:
- Cell type
Sources & Author
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Malignant Mesothelioma. National Cancer Institute. Retrieved from: https://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq. Accessed: 10/15/18.
- 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.
- 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.