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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.
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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:
- Pleural mesothelioma forms in the lining around the lungs (the pleura).
- Peritoneal mesothelioma forms in the lining around the abdominal cavity (peritoneum).
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 (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
EPP survival rates are slightly higher than the rate for all patients (surgery and non-surgery).
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.
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.
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.
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.
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.
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
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.
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.
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.
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
- 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.
- 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.
- 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.
- 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.
- 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.