Aggressive Mesothelioma Surgery Benefits More Patients

Treatment & Doctors
Reading Time: 3 mins
Publication Date: 10/11/2017
Fact Checked
Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.
Reviewed

Asbestos.com is the nation’s most trusted mesothelioma resource

The Mesothelioma Center at Asbestos.com has provided patients and their loved ones the most updated and reliable information on mesothelioma and asbestos exposure since 2006.

Our team of Patient Advocates includes a medical doctor, a registered nurse, health services administrators, veterans, VA-accredited Claims Agents, an oncology patient navigator and hospice care expert. Their combined expertise means we help any mesothelioma patient or loved one through every step of their cancer journey.

More than 30 contributors, including mesothelioma doctors, survivors, health care professionals and other experts, have peer-reviewed our website and written unique research-driven articles to ensure you get the highest-quality medical and health information.

About The Mesothelioma Center at Asbestos.com

  • Assisting mesothelioma patients and their loved ones since 2006.
  • Helps more than 50% of mesothelioma patients diagnosed annually in the U.S.
  • A+ rating from the Better Business Bureau.
  • 5-star reviewed mesothelioma and support organization.
Learn More About Us

Testimonials

"My family has only the highest compliment for the assistance and support that we received from The Mesothelioma Center. This is a staff of compassionate and knowledgeable individuals who respect what your family is experiencing and who go the extra mile to make an unfortunate diagnosis less stressful. Information and assistance were provided by The Mesothelioma Center at no cost to our family."
Lashawn
Mesothelioma patient’s daughter
  • Google Review Rating
  • BBB Review Rating

How to Cite Asbestos.com’s Article

APA

Povtak, T. (2020, October 16). Aggressive Mesothelioma Surgery Benefits More Patients. Asbestos.com. Retrieved October 7, 2022, from https://www.asbestos.com/news/2017/10/11/aggressive-mesothelioma-surgery-benefits-more-patients/

MLA

Povtak, Tim. "Aggressive Mesothelioma Surgery Benefits More Patients." Asbestos.com, 16 Oct 2020, https://www.asbestos.com/news/2017/10/11/aggressive-mesothelioma-surgery-benefits-more-patients/.

Chicago

Povtak, Tim. "Aggressive Mesothelioma Surgery Benefits More Patients." Asbestos.com. Last modified October 16, 2020. https://www.asbestos.com/news/2017/10/11/aggressive-mesothelioma-surgery-benefits-more-patients/.

Surgeons operating on patient

Patients diagnosed with the worst cases of pleural mesothelioma could benefit the most from the aggressive surgery they often are denied, according to one recent study.

The findings have raised questions about the restrictive surgery selection process at many specialty centers handling mesothelioma, the rare and aggressive cancer caused by asbestos exposure.

“In some cases, patients are not being offered the aggressive surgery that could help their quality of life,” lead author Dr. Wickii Vigneswaran, mesothelioma specialist and chief of thoracic surgery at the Loyola University Medical Center, told Asbestos.com. “Our findings showed that this subgroup of patients could be helped with surgery.”

The World Journal of Surgery published the results of the 2017 study, which was conducted by doctors and researchers at Loyola and the University of Chicago Medical Center.

“The findings kind of surprised us,” Vigneswaran said. “This needs to be considered when it comes to offering surgical treatment. These patients can benefit.”

Sicker Patients Improved the Most

The study was based on 114 patients who underwent pleurectomy/decortication (P/D) surgery in Chicago from 2008 to 2015. They were given health assessments prior to surgery and again at the different intervals of 1, 4-5, 7-8 and 10-11 months after surgery.

Researchers found the sickest patients at baseline, which are those with larger tumor volume and nonepithelial histology (usually not surgical candidates), showed more improvement to quality of life after surgery than the healthier patients.

Patients who started with a good performance status, epithelioid histology and smaller tumor volume (often deemed prime surgical candidates) did not show as much improvement after the operation.

Sicker patients typically are excluded from aggressive surgical options because of the mortality and morbidity risks, along with a quality of life concern after undergoing such an extensive procedure. Many thoracic surgeons have become increasingly selective in recommending mesothelioma patients for surgery.

Less than one-third of all pleural mesothelioma patients undergo aggressive surgery.

Quality of Life vs. Quantity of Life

The P/D surgery, which is not as radical as the extrapleural pneumonectomy, involves removing the lining surrounding the lungs, parts of the diaphragm or the entire organ, and any tissue in the thoracic cavity where cancerous tumors are found.

Overall median survival in the study group was 15.2 months, but it differed upon the tumor volume and histology. Survival was longer for those with epithelioid histology and lower tumor volume at baseline. The higher tumor volume at baseline was consistent with shorter survival time.

“The quality of life was much improved [for those with higher tumor volume], even when the quantity of life was not,” Vigneswaran said. “That could justify taking on the surgical treatment.”

According to study results, those with the higher tumor volume and nonepithelial subtype also showed a quicker quality of life improvement than the healthier group after surgery.

“The larger-volume group experienced significantly less deterioration in physical, role and social functioning as well as significantly less fatigue, pain and dyspnea when compared to the small volume group,” the authors wrote.

Vigneswaran performed each of the study surgeries at the University of Chicago before joining Loyola in January 2016 to build a new mesothelioma program that he believes can be one of the country’s best.

“Patients who may be excluded by many from surgery because of limited improvement in survival, can benefit greatly in their quality of life following P/D surgery,” he wrote in the study. “P/D extends the life in patients who had favorable characteristics, while also improving quality of life for patients with unfavorable characteristics.”

Medically Reviewed by Top Mesothelioma Doctors
Free Mesothelioma Guide