Mesothelioma Survival Rate
Survival rate refers to the percentage of people with a certain type and stage of the mesothelioma patient who survive for a specific period of time after their diagnosis. Most of these statistics focus on 5-year survival rate. The overall 5-year relative mesothelioma survival rate for 1998-2002 has been found approximately 9 percent.
There are no national statistics available for different stages of cancer or treatments that people may have received. The statistics presented here are pulled together from a variety of sources, including information from the American Cancer Society as well as recent clinical trials and the National Cancer Institute. . These statistics are only intended as a general guide and cannot be regarded as any more than that. These statistics are averages based on large numbers of patients. They cannot predict exactly what will happen any one patient. No patients are exactly alike and response to treatment also varies from person to person.
.For both types of mesothelioma (pleural and peritoneal mesothelioma), patients are often told that they have less than a year to live. But mesothelioma specialists, working in leading cancer centers throughout the world, often report better statistics than this based on clinical trials that they are carrying out. Some of these are reported below.
In the medical literature, average survival times for people with mesothelioma have ranged between 4 and 18 months, depending on the study. About 10% of people with mesothelioma live at least 5 years after being diagnosed.
For those people who have been diagnosed and treated in the earlier stages of the disease, there is little information to draw on. There have been reports that quote survival rates of up to 1 in 2 (50%) after 2 years. So the range of survival times is very wide. Survival depends on stage as well as other factors. Here are the main things that influence mesothelioma survival rate:
- Stage of mesothelioma
- Size of the tumor
- Whether this tumor can be removed completely by surgery
- The quantity of fluid in the chest or abdomen
- The age and general health of the patient
- The type of cancer cells and their look under a microscope (so-called epithelioid subtype is better)
Survival rates from clinical trials
Although there are results from quite a few trials available, they are often quite small studies involving fewer than 20 patients or so.
At the Dana-Farber Cancer Institute in Boston, doctors followed 120 patients, with different types of pleural mesothelioma, from 1980-1995. All these patients were treated with surgery to remove the lung and pleura (pleural pneumonectomy), followed by a combination of chemotherapy and radiotherapy, with or without immunotherapy. 54 out of the 120 (45%) patients in this trial were alive 2 years later and 26 out of the 120 (22%) patients were alive 5 years later.
Patients with sarcomatoid and mixed mesothelioma had a poorer prognosis. Of the patients with these types of mesothelioma only 20% were alive 2 years later and by 5 years later, all had died.
Patients with epithelioid type tumours and no cancer in the lymph nodes had a much better outlook. Nearly 3 people out of every 4 (74%) were alive 2 years later and more than 1 person in every 3 (39%) alive 5 years later. (The full results of this trial are published in the February 2002 edition of the medical magazine Seminars in Oncology, volume 29, issue 1, pages 41-50.)
A more recent study involved patients with unresectable tumors for whom surgery was not an option, Based on the results of other smaller trials, a study was conducted using pemetrexed in combination with cisplatin versus cisplatin alone. These patients had no surgery and also no previous chemotherapy. They were also given folic acid and vitamin B12 to prevent toxicity of the chemotherapy. The patients given the two chemotherapeutic agents had significantly improved survival times - 25% to 30% times longer survival. These are the type of patients who received no benefit from other treatments. (From the Journal of Clinical Oncology in 2003.).
Sequential treatment, in which an extrapleural pneumonectomy is followed by chemotherapy and/or radiotherapy, has shown promise. In one trial, trimodality therapy, involving chemotherapy and radiotherapy, was used with 183 patients who had early-stage disease and underwent EPP followed by radiotherapy.18 The mortality rate was 3.8% and median overall survival was 19 months. In a group of 31 patients with epitheliod tumors and no evidence of extrapleural nodal involvement, median survival was 51 months. In other words, half the patients lived 51 months, which is over 4 years. Sugarbaker DJ et al. (1999) Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients. (From the Journal of Thoracic and Cardiovascular Surgery 1999)
A review article in Nature Clinical Practice Oncology in 2008 summarized the following points:- Malignant pleural mesothelioma remains a highly lethal cancer, which is increasing in incidence in several countries
- Chemotherapy is the mainstay of treatment for the majority of patients presenting as inoperable
- Despite the therapeutic plateau of the past 20 years, randomized trials have now confirmed that combining antifolates with platinum-based therapy confers a survival benefit (this means that the pemetrexid cisplatin combination is working)
- No standard therapy has yet been defined in the second-line setting
- New approaches for treating this disease are arising from a better understanding of the underlying biology and are beginning to be translated into the clinical setting
Although the 5 year survival may have been 9 to 10% in the past, as new therapies are being used, those statistics will change in the future.
Please look at the "Hope" page to see stories of people who beat the odds and are living long useful lives after diagnosis.
Anna L. Kaplan, M.D.