Longer Mesothelioma Survival Possible with Aggressive Treatment

A “significant proportion” of patients diagnosed with mesothelioma can expect to live three years or longer with the right treatment protocol. That’s the conclusion of one of the nation’s leading mesothelioma experts. Reporting in the European Journal of Cardiothoracic Surgery, Dr. David Sugarbaker writes that, although many patients diagnosed with mesothelioma are told they have less than a year to live, his latest research confirms that, when properly selected and given aggressive multimodality treatment, it is possible to survive mesothelioma for much longer.

Numerous studies have shown that cytoreductive surgery through extrapleural pneumonectomy along with adjuvant chemotherapy and radiation can be effective at battling mesothelioma. However, because the surgery itself is so invasive and carries its own health risks, proper patient selection is critical. A new retrospective study conducted by Dr. Sugarbaker and his team at Brigham and Women’s Hospital in Boston sheds more light on which mesothelioma patients have the best chance of surviving for three years or longer.

The team examined the records of 636 malignant pleural mesothelioma patients who had had extrapleural pneumonectomy between January 1988 and May 2007 and confirmed their health status as of May 2010. Of the 636 patients studied, 117 (18%) survived at least three years after surgery, including 26 who were still alive and 4 who had been lost to follow-up. Of the three-year survivors, a third were female, just over half (52%) had mesothelioma only on the left side of the chest, and the most were 56 years old, or younger. Of the 117 patients who survived three years or more, most had the epithelial variety of mesothelioma and the median survival was 59 months. Age only appeared to have a significant survival advantage among the female patients. Those with the longest survival (median of greater than 7 years) were under 56.

But the authors of the study conclude that there is good news here, even for mesothelioma patients who do not fit into one of these longer-surviving categories. They write, “Although favorable prognostic features were more common, the cohort of 3-year survivors included a substantial number of patients with late-stage disease.” They say their findings support the role of extrapleural pneumonectomy as part of a multimodality approach and call for further studies that can help improve patient selection.

Sources:

Sugarbaker, DJ, “Clinical and pathological features of three-year survivors of malignant pleural mesothelioma following extrapleural pneumonectomy”, February 8, 2011, European Journal of Cardiothoracic Surgery, Epub ahead of print.