A new study of mesothelioma patient outcomes is raising important questions about recommended treatment protocols for patients with all types of malignant pleural mesothelioma. The study, a collaborative effort between the Maryland Proton Treatment Center, Allegheny General Hospital in Pittsburgh and Penn Medicine in Philadelphia, was the largest of its kind: it compared survival times between patients diagnosed with all three cell types of pleural mesothelioma without surgery as well as with, and found a clear survival advantage for patients undergoing surgery of all types.
The study’s results are in direct conflict with the National Comprehensive Cancer Network’s current recommendations for mesothelioma patients. Though the network only promotes surgery for patients diagnosed with epithelioid mesothelioma, the study published in the journal Clinical Lung Cancer has indicated that no matter the histological subtype, patients benefit from aggressive surgery, and that failure to pursue surgery is cutting survival time short. The results are garnering a great deal of attention, in large part because of the number of patients it represents: there were 4,207 patients in the National Cancer Data Base who met the study’s criteria, an unusually large representation for such a rare condition.
Of the three different cell types identified in mesothelioma patients, epithelioid is the most common, with sarcomatous and biphasic disease representing roughly 40% of cases diagnosed. The survival times without surgery for each of the three are starkly different, with overall median survival for epithelioid found to be 16.5 months, biphasic at 11 months, and sarcomatous at 7.6 months. The study revealed that when these patients submitted to either pleurectomy and decortication (P/D) or the more aggressive extra pleural pneumonectomy (EPP), median survival times increased more than 6 months for those with the epithelioid cell type; more than 5 months for those with the biphasic cell type and more than 4 months for those with the sarcomatoid cell type. Despite these dramatic increases in survival, only about one in five mesothelioma patients have these surgeries, in part because physicians have believed that they have too negative an impact on the patient’s quality of life. The results of this study may change this trend, as it clearly indicates a dramatic extension of life for patients struggling with this challenging illness.
If you or someone you love has been diagnosed with malignant mesothelioma and you need information on the options available to you, the Patient Advocates at Mesothelioma.net can help. Call us today at 1-800-692-8608.