Prognosis Model Weighs Factors for Post-Op Mesothelioma Survival

The burning question that leaps off your tongue when your doctor recommends that you undergo extrapleural pneumonectomy is “How much more time will this mesothelioma surgery give me?”

It’s understandable why that would be your first question. Mesothelioma survival is the bottom line for you. It’s why you’d agree to have that surgery in the first place.

Unfortunately, your doctor can’t answer your question with much in the way of certainty. The best he or she can do is offer a prognosis that states your extended mesothelioma survival time broadly.

“You can look forward to living anywhere from an additional six months to six years — maybe more if we include chemotherapy, radiation and some targeted molecular therapies,” your doctor might respond.

Vague answers like that may soon cease, if a model developed by researchers in Italy is proven successful.

Mesothelioma Prognosis Model Details

Researchers at Italy’s National Cancer Institute in Milan have come up with a prognosis model to help your doctor more precisely predict mesothelioma survival following an extrapleural pneumonectomy.

The researchers described their prognosis model in a recent issue of the journal Annals of Thoracic Surgery. They also acknowledged that their model is controversial.

In a nutshell, the model calculates postsurgical mesothelioma survival by taking into account up to four independent factors and then scoring them as a whole.

The first factor in the mix is your age at the time of mesothelioma surgery. The second is the histology of the type of mesothelioma cells growing inside you — epithelioid, biphasic or sarcomatoid.

The third factor is the tricky one. It’s the measure of how much asbestos exposure you suffered throughout your lifetime.

This factor is tricky because accurately measuring how much exposure you had across a span of decades is extraordinarily difficult to do. This is also where the controversy comes in.

Many scientists are of the opinion that you can develop the most aggressive case of mesothelioma imaginable from just a single small exposure to asbestos.

Or that you can develop the least aggressive case of mesothelioma imaginable after many multiple, high-intensity exposures to asbestos.

How bad your case actually will be depends not on the frequency or degree of exposure but rather on your unique genetic makeup.

The criticism of the new prognosis model is that it does not appear to that into account the genetic attributes of the individual patient.

The fourth factor is not controversial at all. It considers the ratio between metastatic and resected lymph nodes.

Malignant Pleural Mesothelioma Patients Studied

The researchers say a reliable postsurgical mesothelioma prognosis can be made with any one of these four factors by itself.

The reason the prognosis can be made with less than the full four is that these are independent factors. Even so, the more factors that can be weighed together, the more precise the prognosis.

To create this mesothelioma survival prognosis model, the researchers retrospectively reviewed clinicopathologic and oncological factors of 468 malignant pleural mesothelioma patients.

Each mesothelioma patient in the cohort had undergone extrapleural pneumonectomy. These surgeries took place at nine thoracic surgery centers in Italy between 2000 and 2010.

“This easy-to-use model could help physicians in stratifying the treatment outcome and, eventually, tailoring postoperative treatment by identifying those patients who require close surveillance or more aggressive cancer therapy,” the researchers said.