Age appears to be one of the biggest predictors of mesothelioma survival after surgery. This holds true no matter which kind of surgery a patient has.
A new study from the University of Pennsylvania compared the outcomes of more than 2,000 mesothelioma surgery patients. They compared them by surgical type. They also compared their survival with that of people who did not have surgery.
Mesothelioma survival after surgery was consistently longer for younger patients. The risk of death within a few months went up a little bit with each year of age. The news could help patients and doctors make better treatment decisions.
Surgical Procedures for Mesothelioma
Operating on mesothelioma patients is controversial. Mesothelioma tumors are irregularly shaped and difficult to remove completely. Surgical procedures for mesothelioma are complex and carry a high risk of complications and death. Many patients are not even candidates for surgery.
The best odds for mesothelioma survival after surgery are at high-volume centers. Surgeons in these centers usually have experience with one of the two major types of mesothelioma surgery, EPP and P/D.
EPP surgery involves removal of the mesothelioma tumor as well as one lung. P/D removes the tumor and other at-risk tissue but leaves the lungs in place. Both of these procedures are risky but both can be lifesaving. Studies suggest that mesothelioma survival after surgery depends heavily on careful patient selection.
Older Patients = Shorter Mesothelioma Survival After Surgery
In the new University of Pennsylvania study, 2,125 mesothelioma patients had surgery. Researchers compared their outcomes with each other. They also compared them with 8,598 patients who did not have surgery. They wanted to identify the main influences on mesothelioma survival after surgery.
Five percent of surgery patients died within 30 days of the procedure. Just under 13 percent died within three months. There were no short-term mortality differences between EPP and P/D. Ten percent of patients who did not have surgery died within 30 days. A quarter of them died within 90 days.
Several factors influenced mesothelioma survival after surgery. They included age, number of other health conditions, being treated at a high-volume center, and having chemotherapy in addition to surgery. The age-related risk was the only one that went up with each additional year.
“The patient (yearly) incremental increase in age conferred 2.0% (30 day) and 2.2% (90 day) increased risk of mortality,” the authors report. For every additional year, the likelihood of long-term mesothelioma survival after surgery declined by two percent.
The research team concludes that age-related risk estimates should be part of the decision-making process for patients and doctors considering mesothelioma surgery.
Wright, C, et al, “Quantitation and predictors of short-term mortality following extrapleural pneumonectomy, pleurectomy/decortication, and nonoperative management for malignant pleural mesothelioma”, November 2020, Journal of Thoracic Disease, Vol. 12, No. 11, http://jtd.amegroups.com/article/view/46076/html