A new study by physicians at Leiden University Medical Center in the Netherlands is helping doctors better understand how scar tissue formed during mesothelioma treatment affects whether surgery is possible and how well it works. These findings could help doctors better choose the right patients for surgery and improve patient outcomes.
Mesothelioma Surgery Outcomes Depend on the Amount of Scar Tissue Present
Surgery is often part of mesothelioma treatment, but the results of the MARS-2 clinical trial created a dramatic shift in perspectives on its role. That study found that patients who received chemotherapy followed by surgery had shorter survival times on average than those who received chemotherapy alone. The Dutch researchers analyzed the role of fibrosis—the scar tissue that forms when chemotherapy or immunotherapy kills mesothelioma cells. They found that the amount and location of scar tissue significantly affect whether surgeons can successfully remove the remaining tumor tissue and how much healthy tissue remains afterward.
The surgical challenge that they identified is notable: too little fibrosis means the thin mesothelial lining remains fragile and difficult to grasp and separate from the underlying lung, like trying to peel a wet tissue from a surface. Too much fibrosis creates dense adhesions that lock the lung to the chest wall, making it nearly impossible to remove completely. An intermediate amount of fibrosis—enough to create a thicker, more cohesive layer—appears most favorable for successful mesothelioma surgery.
Mesothelioma Treatment Response Measured by How Much Scar Tissue Replaces Tumor
Doctors are increasingly using a measure called Major Pathologic Response to assess how well neoadjuvant therapy—treatment given before surgery—is working against mesothelioma. A Major Pathologic Response means that 90% or more of the tumor has been replaced by scar tissue, necrosis, or other non-cancerous material, with only 10% or less remaining as viable cancer cells. Studies show mesothelioma patients achieving this level of response have significantly better survival than those who don’t, making it a valuable tool for predicting which patients are most likely to benefit from surgery.
For mesothelioma patients being evaluated for surgery after chemotherapy or immunotherapy, these findings highlight that the amount of scar tissue visible on scans and present in biopsies may become an increasingly important factor in determining whether proceeding to surgery is their best option.
If you or someone you love has been diagnosed with mesothelioma, research like this offers greater insights and hope for better outcomes in the future. For more information, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.
