Mesothelioma surgery is usually quite effective. Unfortunately, the viciously aggressive asbestos cancer often returns — and often in the same spot.
However, going under the knife a second time may increase your chances for longer survival, scientists now say.
Researchers from University Hospital Zurich in Switzerland assert that surgical removal of a mesothelioma tumor that returned after surgery once before can be beneficial.
But there’s a catch. Second-time mesothelioma surgery is effective for some, not all, mesothelioma patients.
Generally, mesothelioma surgery involving a specific section of the lung region is a one-time proposition.
But the researchers found that for a minority of patients it is possible to perform surgery again where there has been localized recurrence of a mesothelioma tumor.
Post-Op Mesothelioma Recurrence Is Common
The researchers came to this conclusion in the course of studying local recurrence rates. According to the team, local recurrence of malignant pleural mesothelioma is the type of relapse seen most often after surgery.
The study began with team members sifting through hospital medical records. They were looking for patients who had undergone macroscopic complete resection via extrapleural pneumonectomy.
The researchers identified 136 patients that fell into this category, and each had been on the operating room table at some point between 1999 and 2013.
Of the 136 patients, 106 were found to have suffered a local recurrence of the mesothelioma by late 2014.
Because the researchers had access to the full record of each patient’s surgery, they were able to pinpoint where the tumors were originally located and compare that to the site of the recurrence.
Second-Line Mesothelioma Surgery Worked Best
It turned out that half of the 106 patients were recurrence free more than 9 months after surgery, while the other half were recurrence free less than 9 months after surgery.
Among these patients, 74 percent experienced recurrence very near to or in exactly the same place as the original tumor. For the remainder, recurrence happened at a site some distance away.
Interestingly, most who experienced localized recurrence also experienced distant recurrence at the same time.
If you had localized recurrence only, you could expect to survive an average of 12 months after the mesothelioma came back.
But you could only expect to survive half that long if it recurred both locally and distally. You could expect to survive about a month or two less than that if the recurrence was distant only.
It turned out that 78 of the 106 patients received a second-line therapy after tumor recurrence — chemotherapy, radiation therapy, surgery or some combination of these three.
Whichever one of these second-line therapies was given, it resulted in the patient surviving significantly longer than patients who received no second-line therapy.
The big bombshell was the researchers’ discovery that patients who received surgery as the second-line treatment experienced the longest survival of all.
The title of the researchers’ article is “Relapse pattern and second-line treatment following multimodality treatment for malignant pleural mesothelioma.”
In addition to publishing their findings in the European Journal of Cardio-Thoracic Surgery, the researchers also shared them at the 23rd European Conference on General Thoracic Surgery in Lisbon, Portugal earlier this year.