Surgery has historically been one of the most effective treatments for pleural mesothelioma. During surgery, medical teams can remove tumors so that they don’t grow or spread to other parts of the body. However, the results from a new study question how effective surgery may be for pleural mesothelioma.
There are two main surgeries used to treat pleural mesothelioma:
- Extrapleural pneumonectomy (EPP), which removes the entire lung along with the pleura (lung lining), heart lining, and diaphragm
- Extended pleurectomy with decortication (EPD), where the surgeon only removes the pleura and any visible tumor tissue in the heart lining and diaphragm, sparing the affected lung itself
In the latest Mesothelioma and Radical Surgery (MARS) trial, researchers tested surgery with chemotherapy versus standalone chemotherapy in over 350 patients.
What they found was that surgery was often not worth the added cost or risk to patients who could live longer with other mesothelioma treatments alone.
The First MARS Trial: Evaluating EPP Surgery
The purpose of the first MARS trial was to determine whether EPP surgery helped patients who previously received chemotherapy.
This 2011 trial found that patients who got EPP surgery had poorer outcomes compared to those who didn’t.
Still, EPP remains one of the most widely used surgeries for patients with early-stage pleural mesothelioma.
Mesothelioma doctors recommend surgery on a case-by-case basis and may start with other treatments like chemotherapy and radiation if your cancer has spread too far to operate on.
Get our Free Mesothelioma Guide to learn more about treatment, clinical trials, and top specialists and cancer centers who can help you live longer.
About the MARS 2 Study: Evaluating EPD Surgery & Chemotherapy
The MARS 2 clinical trial evaluated the effectiveness of extended pleurectomy decortication with chemotherapy by focusing on four main outcomes:
- Overall survival
- Safety
- Quality of life
- Cost-effectiveness
A total of 335 patients participated, 166 of whom received chemotherapy alone and 169 of whom got chemotherapy and surgery. Among those who had surgery, the majority underwent an EPD, while the others received a P/D.
MARS 2 Trial Results Show Surgery Has Limited Success
Despite what the study researchers predicted, the MARS 2 trial found that surgery didn’t improve patient survival.
The study team also found that surgery resulted in:
- Higher Costs. The overall cost of care was much higher for patients who received pleural mesothelioma surgery, making it a less cost-effective option compared to chemotherapy.
- More Complications. Those treated with surgery had more serious health issues (318 events) than those who received standalone chemotherapy (169 events). The surgery group experienced more heart and lung complications, as well as infections, and needed additional medical procedures as a result.
- Poorer Quality of Life. Patients who only had chemotherapy reported better quality of life. In contrast, those in the surgery group reported more pain, fatigue, breathing problems, sleep issues, appetite loss, and financial difficulties.
- Shorter Survival. People who had both surgery and chemotherapy had a shorter average life expectancy (19.3 months) than those who had only chemotherapy (24.8 months).
Many patients lose hope when they hear they don’t qualify for surgery. However, these results show they may not actually be missing out on life-changing clinical care. Even without surgery, patients in the study were able to live longer lives with fewer side effects.
If you or a loved one has been diagnosed with mesothelioma and are unsure of what to do next, Mesothelioma Hope’s Free Doctor Match service can help. We’ll connect you with top specialists in your area who can offer the best medical care.
Get Personalized Support on Your Mesothelioma Journey
At Mesothelioma Hope, we’re dedicated to helping patients, their families, and caregivers at every phase of their cancer battle. We have decades of experience and understand how mesothelioma affects entire families.
Our Patient Advocates offer personalized support to help you:
- Find a mesothelioma specialist
- Get a second opinion to confirm your diagnosis
- Understand your treatment options and side effects
- Enroll in mesothelioma clinical trials
- Get financial compensation for mesothelioma
“I would strongly encourage patients to do some research on what’s available for financial help in getting treatment, because there are alternative treatments for cancer that may save your life.”
We’re here for your family — whatever your needs may be. Contact us now or request our Free Mesothelioma Guide to get started.
