A new study from the University of Chicago has a positive message for older people with malignant pleural mesothelioma: Lung-sparing surgery may be no more risky for you than it is for younger patients, even if you have other health problems.
The team performed a retrospective review of 117 consecutive mesothelioma patients who underwent the lung-sparing surgical procedure known as extended pleurectomy and decortication between 2008 and 2013. While extended pleurectomy stops short of removing a lung, it does include the entire pleural membrane (where mesothelioma starts), all or part of the diaphragm, the lining around the heart, and other at-risk tissues. It is a major thoracic surgery with a goal of keeping mesothelioma from regrowing from residual cells.
For the purposes of the study, the pool of surgery patients was divided between those who were younger than 70 and those who were older. Not surprisingly, many of the 54 over-70 patients suffered from a number of other health problems. Most had high blood pressure and almost a quarter of them suffered from coronary artery disease. But even with these other conditions, neither the complication rate nor the survival rate was worse among the older mesothelioma patients than the younger ones.
“Major complications occurred in 3 patients in the older group and 7 patients of the younger group,” reports author Trevor Williams, MD, MPH, of the University of Chicago. “There were 2 deaths in each group after surgery.”
In fact, although the difference was not statistically significant, the older mesothelioma patients who underwent extended pleurectomy actually lived slightly longer as a group than the younger surgery patients – a median of 15.6 months versus 14 months. The 1 and 2-year survival statistics were also very similar. Older patients had a 1-year survival rate of 64% versus 55% in the younger group. Twenty-nine percent of the older mesothelioma patients lived for at least 2 years after surgery while 32% of the younger patients did so.
The authors conclude that, although age is often associated with multiple health problems in mesothelioma patients, these problems do not necessarily translate into more postoperative complications or shorter survival. The new study was published in the Annals of Thoracic Surgery.
Williams, T et al, “Extended pleurectomy and decortication for malignant pleural mesothelioma is an effective and safe cytoreductive surgery in the elderly”, August 25, 2015, Annals of Thoracic Surgery, Epub ahead of print