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Researchers at the University College London sought to estimate whether patients with malignant mesothelioma who undergo surgery to remove a portion of the cancerous lining of the lung or abdomen survive longer than patients who receive other kinds of treatment. Mesothelioma is a cancer of the lining of the lung or abdomen closely associated with asbestos exposure.

Treatments typically available to patients diagnosed with malignant mesothelioma are surgery, chemotherapy and radiation or a combination of the three. This is known as multi-modality treatment, or more simply a multi-pronged assault on the cancer. To analyze the medical data, researchers divided the data on mesothelioma patients into four groups:

• Patients who did not have surgery;
• Patients who had their chest cavity opened surgically, but did not have organs removed;
• Patients who had tissue such as a lung and the lining of the lung removed, but did not undergo chemotherapy afterward;
• Patients who had organs and cancerous tumors removed as well as chemotherapy and/or radiation.

The researchers estimated the survival advantage of treatment approaches that included surgery at nine months at best. They said that was the most optimistic estimate, assuming that the difference in survival was entirely attributable to the treatment and not to the patient’s relative fitness to withstand surgery. They said this should be taken into consideration given the risks of surgery.

Patients who had surgery and chemotherapy or radiotherapy showed the best results, surviving about 32 months on average – or roughly twice as long as patients who had other types of treatments, researchers reported. The study was published in the European Journal of Cardiothoracic Surgery.

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