What Is Epithelioid Mesothelioma?
Epithelioid mesothelioma is the most common cell type of mesothelioma, accounting for 50% to 70% of all diagnoses. It generally has the most favorable prognosis and responds best to treatment, including surgery and chemotherapy.
Overview of Epithelioid Mesothelioma
Epithelioid mesothelioma is characterized by uniform, cube-shaped cells that tend to adhere to one another rather than spreading individually. This cell behavior makes epithelioid tumors generally slower-growing and more responsive to treatment than other mesothelioma cell types.
Under a microscope, epithelioid cells have clearly defined borders and a regular shape. Pathologists use immunohistochemical staining to distinguish epithelioid mesothelioma from adenocarcinoma and other cancers that can appear similar histologically.
Prognosis and Survival
Patients with epithelioid mesothelioma consistently have the longest median survival of any mesothelioma cell type. With multimodal treatment that may include surgery, chemotherapy, and radiation, some patients survive well beyond the median. Long-term survivors of mesothelioma — those living five years or more — are disproportionately from the epithelioid subtype.
Stage at diagnosis remains important even within the epithelioid category. Patients diagnosed at earlier stages with purely epithelioid tumors have the best statistical outcomes and are most likely to be candidates for aggressive surgical approaches.
Treatment Options
Epithelioid mesothelioma patients have the widest range of treatment options. Surgical procedures such as extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D) may be recommended for eligible patients. First-line chemotherapy typically combines pemetrexed with cisplatin or carboplatin, and immunotherapy with nivolumab and ipilimumab has become a standard option.
Patients with epithelioid mesothelioma are also strong candidates for clinical trials testing newer approaches. Securing financial compensation through legal claims can help cover the costs of specialized treatment and travel to experienced mesothelioma treatment centers.
- Frequency: 50–70% of all mesothelioma diagnoses
- Median Survival: 12–24 months, longer with multimodal treatment
- Cell Behavior: Slower growth, more uniform cell structure, better treatment response
- Treatment Options: Most eligible for surgery, chemotherapy, immunotherapy, and clinical trials
Reviewed by: Rod De Llano, J.D. — Texas Bar — 30+ years mesothelioma litigation
Last updated: March 15, 2026
Sources: World Health Organization — Classification of Thoracic Tumours, Lung Cancer — Epithelioid Mesothelioma: Current Evidence and Outlook, Journal of Clinical Oncology — Treatment Outcomes by Histological Subtype
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