Mesothelioma Prognosis and Survival Rates: Women and Extended Pleurectomy Decortication

Mesothelioma Prognosis and Survival Rates: Women and Extended Pleurectomy Decortication

Malignant pleural mesothelioma is a fast-spreading cancer tied to asbestos. Sadly, patients on standard treatments survive just 12–18 months. However, recent studies show better outcomes for some, especially women. They receive ePD surgery, part of a combined treatment.

Now, a new article examines mesothelioma patient outcomes. It looks at the factors impacting survival and the benefits of specific treatments.

Understanding Pleural Mesothelioma and the Pleural Space

Pleural mesothelioma is a cancer in the pleura, the thin membrane around the lungs and chest. It’s mainly caused by asbestos exposure, from work or the environment.

This cancer affects the pleural space, crucial for lung movement during breathing. A tumor or pleural effusion, excess fluid, can harm breathing and worsen mesothelioma symptoms.

Clinical Trial Insights: The MARS 2 Study

The MARS 2 trial, a major study in The Lancet Respiratory Medicine, looked at ePD for pleural mesothelioma. It found that chemotherapy alone led to better survival (24.8 months) than ePD (19.3 months). Also, the surgery group had worse quality of life, more side effects, and higher costs.

These results suggest we should rethink ePD for mesothelioma. This is due to the difficulty in fully removing the cancer and the long recovery time. The study highlights the need for expert surgeons and careful patient selection.

Prognostic Factors and Survival Rates in Women with Pleural Mesothelioma

A recent study focusing on female patients with pleural mesothelioma treated with ePD has provided valuable insights into prognostic factors and survival rates. The study enrolled 114 consecutive female patients treated over 11 years at a high-volume institution. Key findings include:

  1. Improved Survival Rates: Women with epithelioid histology who underwent ePD had a median survival of 44.4 months and a 5-year survival rate of 36.4%. This contrasts sharply with the general median survival of 12–18 months for unresectable patients.
  2. Impact of Complete Resection: Achieving macroscopic complete resection (MCR) significantly improved survival, with a hazard ratio (HR) of 0.3, indicating a 70% reduction in the risk of death compared to those without MCR.
  3. Other Prognostic Factors: Early T status, adjuvant therapy, intraoperative heated chemotherapy (IOHC), age, and epithelioid histology were all associated with better survival outcomes.

Women with Pleural Mesothelioma

A study of women with pleural mesothelioma highlights the need for a combined treatment approach. It shows that women, especially those with the common epithelioid type, benefit. Their survival increases, and the risk of death after surgery drops. Trials like MARS 2 are crucial. They refine treatments and offer guidance for mesothelioma care.

Joining a trial can give mesothelioma patients access to new treatments, better care, and a chance to help research. As oncology advances, trials will be key in fighting mesothelioma. They bring hope for better outcomes and a higher quality of life.


Lapidot, Moshe, Emanuele Mazzola, and Raphael Bueno. “Prolonged Survival and Novel Prognostic Factors in Women with Pleural Mesothelioma Treated with Extended Pleurectomy Decortication.” Translational Lung Cancer Research 13, no. 4 (April 29, 2024): 811–20.

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