Surgery OK for Some Mesothelioma Patients Over 70

Elderly patients sometimes hear about the benefits of mesothelioma surgery and then ignore it.

They think surgery isn’t for them because they’re old to go under the knife. Or they think an operation would be pointless at their advanced age.

Or they fear their bodies are too frail to bear up under the physical demands of surgery.

A new study by researchers from Duke University Medical Center suggests that elderly patients under 80 may be potential candidates for mesothelioma surgery despite those concerns.

The researchers suggest that mesothelioma patients in their 70s may find it worthwhile to ask for a multidisciplinary evaluation to determine if surgery is worth investigating as a treatment option.

Researching If Surgery Improves Overall Mesothelioma Survival

The researchers wrote about this in the journal Clinical Lung Cancer. Their article is titled “Surgery Improves OS [overall survival] in Malignant Pleural Mesothelioma.”

To arrive at their conclusions, the researchers evaluated data from the Surveillance, Epidemiology, and End Results (SEER) program.

SEER is believed to be the nation’s most well-developed source of data about cancer incidence and survival. The program is operated by the National Cancer Institute.

Researchers, like the ones from Duke University Medical Center, can access SEER for cancer data on millions of patients. Included is information about the location of each patient’s primary tumor and the type of tumor the patient has.

There is also data about the stage each patient’s tumor was at when first diagnosed, what treatments were tried and the outcomes.

Here, the researchers drew upon all this data to help them determine if mesothelioma overall survival rates were affected by age. A narrower question they wanted to answer was whether surgery was a factor in that survival.

The researchers retrieved data on a total of 879 malignant pleural mesothelioma patients. Of these, 282 received treatment that included surgery.

All of these surgery patients had mesothelioma characterized as being in stage I, stage II or stage III.

The patients who underwent mesothelioma surgery tended to be younger than the patients who did not undergo surgery. The median age of the mesothelioma surgery patients was 67. It was 74 for the non-surgery patients.

The researchers also noted that older mesothelioma patients tended to shy away in larger numbers from surgery. Only 22 percent of those 70 and up had surgery. In contrast, 46 percent of those under 70 had surgery.

Better Mesothelioma Survival for People in Their 70s

Significantly, patients who underwent mesothelioma surgery experienced better 30-day survival rates than did the non-surgery patients.

That trend didn’t change over time. One year on, 63 percent of surgery patients were still slugging away at mesothelioma. Only 44 percent of the non-surgery patients were continuing to do battle with the cancer.

At the end of three years, 21 percent of surgery patients remained in the fight compared to just 11 percent of the non-surgery patients.

The big take-away from this research is that mesothelioma surgery can confer a survival benefit on patients in their 70s. However, the mesothelioma survival benefit does not appear to extend to patients in their 80s.

“Quantitative data to support difficult treatment decisions about when to offer surgery for elderly malignant pleural mesothelioma patients are needed, as a subset of these patients with favorable prognostic factors may experience extended survival by undergoing cancer-directed surgery,” the researchers wrote.

“Future research should focus on evaluating the co-morbidities and characteristics that are most important in the elderly population to optimize both perioperative outcomes and long-term survival,” they added.