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Written By: Devin Golden

Survival Rates and Mesothelioma Surgery

Surgery for mesothelioma has led to increased survival in many patients and even no sign of disease in some cases. These lengthy survival times for patients leads to better survival rates for surgery, which can give patients hope. This page outlines how each surgery can improve your mesothelioma life expectancy.

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Does Surgery Improve Mesothelioma Survival Rates?

Mesothelioma survival rates are higher among patients who had surgery to remove their tumors. Survival rates are a percentage of people who reach a specific survival benchmark, such as one year, two years or even five years. These survival-benchmark percentages are higher for mesothelioma patients who have surgery versus patients who do not have surgery.

Why Does Surgery Improve Mesothelioma Survival?

Chemotherapy, immunotherapy and radiation don’t have the same impact as surgery. These therapies slowly kill tumors and often don’t work quick enough to slow down the growth of the rapidly spreading mesothelioma tumors.

Surgery takes out any visible tumors in just a few hours reducing the danger the cancer poses to the patient. Removing the tumors lowers the chance of the disease returning.

The combination of surgery and other treatments improves survival for many people, which in turn increases survival rates when all data is collected and the survival rates are determined. Find a mesothelioma specialist who can help you increase your survival through surgery.

Mesothelioma Surgeries to Improve Survival

There are three surgeries doctors rely on to remove the mesothelioma tumors and give patients a better survival expectancy. Two of the surgeries are for pleural mesothelioma, and the other surgery is for peritoneal mesothelioma.

Pleural mesothelioma and peritoneal mesothelioma are the two main types of mesothelioma:

The third type of mesothelioma is pericardial mesothelioma. This is a rare type of mesothelioma forming in the lining of the heart. Only 1% of patients have this type, and the survival expectancy is low. Patients with pericardial mesothelioma may be eligible for a pericardiectomy, which removes this lining, but most patients aren’t diagnosed in time.

Extrapleural Pneumonectomy

Extrapleural pneumonectomy (EPP) surgery removes the diseased lung to treat pleural mesothelioma. This surgery is used when tumors have spread to a lung and the only way to remove the majority of the disease is by taking out a lung.

Survival Rates for Extrapleural Pneumonectomy

The average survival for pleural mesothelioma is 12-16 months. A study of 183 patients who underwent extrapleural pneumonectomy revealed a median survival of 19 months. Another study had a 2-year survival rate of 41% for EPP patients.

EPP survival rates are slightly higher than the rate for all patients (surgery and non-surgery).

Pleurectomy/Decortication

Pleurectomy/decortication surgery (P/D), also called pleurectomy with decortication, also treats pleural mesothelioma. This surgery leaves both lungs in the body and focuses on stripping out the pleural lining, where pleural mesothelioma originates. Surgeons say that stripping out the lining can strip tumors off the lung.

Extended Pleurectomy With Decortication

Some surgeons remove part or all of the diaphragm and lining of the heart (pericardium). This version of the surgery is called extended pleurectomy/decortication.

Most surgeons prefer this version since it removes small tumors or wayward cells that are detached from the main tumors. These small tumors could grow after surgery and cause recurrence, so taking out these tumors helps survival rates.

Survival Rates for Pleurectomy/Decortication

Numerous studies tout pleurectomy/decortication as one of the best options for pleural mesothelioma.

The median survival is 20-32 months, depending on the study, and the 2-year survival rate is around 60%. The 5-year survival rate is around 20%.

These survival rates for pleurectomy/decortication are much higher than for people who don’t have surgery. For example, the 5-year survival rate for all mesothelioma cases is 12%, according to the American Cancer Society, and the 2-year survival rate is close to 30%.

Therefore, extended pleurectomy/decortication surgery doubles the 2-year survival rate and nearly doubles the 5-year survival rate for pleural mesothelioma.

Cytoreduction/HIPEC

Cytoreductive/HIPEC surgery treats peritoneal mesothelioma. Cytoreduction is “debulking,” in which doctors remove all visual tumors and diseased tissue, no matter how big or small.

Cytoreduction also may include removing the peritoneal lining, which is where peritoneal mesothelioma forms, plus the omentum, spleen and other non-vital organs in the abdominal cavity. Cytoreductive surgery is usually paired with a heated form of chemotherapy treatment called HIPEC (heated intraperitoneal chemotherapy).

Survival Rates for Cytoreduction/HIPEC

Peritoneal mesothelioma patients can significantly increase their life expectancy by getting this treatment.

The National Cancer Database has records of more than 700 cases of cytoreduction with HIPEC for peritoneal mesothelioma. The average survival of those cases is 38 months (3 years, 2 months).

Compared to the standard 2-year survival rate of 35% for patients with peritoneal mesothelioma, those who had an operative cytoreduction with HIPEC increased their two-year survival rate to approximately 70%.

Cytoreductive/HIPEC Surgery and EPIC

Other uses of cytoreduction with HIPEC led to extraordinary survival rates.

One study using cytoreductive surgery with HIPEC and EPIC (early post-operative intraperitoneal chemotherapy) led to a 5-year survival rate of 75%. This is the highest survival percentage for this survival benchmark among all types of patients.

EPIC is a postoperative chemotherapy where people leave ports in the patient’s chest and apply heated chemotherapy in the weeks after surgery.

Which Mesothelioma Patients Undergo Surgery?

Candidates for surgical treatment are typically those who have been diagnosed with stage 1 or stage 2 mesothelioma. However, patients in stage 3 are sometimes approved for surgery or accepted in clinical trials that use surgery.

Surgery is most effective at improving survival when combined with chemotherapy, immunotherapy or radiation. This multimodal approach has directly resulted in significantly increased survival rates.

Surviving Mesothelioma

Making the decision to have surgery can be hard and there are risks involved with every major surgery. However, numerous eligible patients who chose to have one of these procedures have experienced an improved quality of life, increased survival time and in many cases, survivorship.

Almost every survivor of mesothelioma attributes their success to one of these surgical procedures combined with another treatment. These patients have taken their lives back, by taking every opportunity that came their way to fight their cancer. Learn the steps they took to reach remission in our free Mesothelioma Survival Guide.

Common Questions About Survival Rates and Surgery

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Why does mesothelioma surgery improve survival rates?

Survival rates improve with mesothelioma surgery due to the nature of removing large amounts of tumors and disease during surgery. Each of the surgeries for mesothelioma takes out the diseased tissue and reduces the danger posed to nearby organs. This gives patients more time or may even eliminate the cancer altogether, improving their life expectancy.

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What is the survival rate for pleurectomy/decortication surgery?

The reported survival rate for pleurectomy/decortication surgery depends on the amount of time measured and the study. For instance, in one study, the 2-year survival rate for this surgery is around 60%, and the 5-year survival rate is around 20%. This surgery treats pleural mesothelioma.

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What is the survival rate for extrapleural pneumonectomy surgery?

The reported survival rate for extrapleural pneumonectomy surgery depends on the amount of time measured and the study. For instance, in one study, extrapleural pneumonectomy had a 2-year survival rate of 41%. This surgery treats pleural mesothelioma.

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What is the survival rate for cytoreductive surgery?

The survival rate for cytoreductive surgery is impacted by the use of HIPEC with the operation. HIPEC is a form of heated chemotherapy and is administered immediately after surgical resection. The 2-year survival rate for cytoreduction with HIPEC is approximately 70%, which is much higher than the survival rate of 35% for all peritoneal mesothelioma patients.

Sources & Author

    1. 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.
    2. Pleurectomy Decortication in the Treatment of Malignant Pleural Mesothelioma. Annals of Surgery. Retrieved from: https://journals.lww.com/annalsofsurgery/Abstract/9000/Pleurectomy_Decortication_in_the_Treatment_of.93886.aspx. Accessed: 12/07/2020.
    3. 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/pubmed/31285889. Accessed: 07/18/19.
    4. Extrapleural Pneumonectomy versus Pleurectomy/Decortication for Malignant Pleural Mesothelioma. Annals of Surgical Oncology. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/33971174/. Accessed: 05/21/2021.
    5. Survival Rates for Mesothelioma. American Cancer Society. Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/survival-statistics.html. Accessed: 11/03/2022.
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.