What Is Mesothelioma Surgery?

Types of Mesothelioma Surgery

Mesothelioma surgery falls into two broad categories: curative-intent (cytoreductive) surgery, which aims to remove as much tumor as possible to extend survival, and palliative surgery, which focuses on relieving symptoms and improving quality of life. The recommended surgery depends on the mesothelioma location, stage, cell type, and the patient’s overall health.

For pleural mesothelioma, the two primary curative procedures are extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). For peritoneal mesothelioma, cytoreductive surgery combined with heated intraperitoneal chemotherapy (HIPEC) has become the standard approach at experienced centers.

Palliative procedures — including thoracentesis and pleurodesis — do not aim to cure the disease but can significantly improve comfort by draining fluid buildup.

Who Is a Candidate for Surgery?

Not every mesothelioma patient is a candidate for curative surgery. Generally, the best candidates have early-stage disease (stage I or II), epithelioid cell type, adequate heart and lung function, and good overall physical condition. Patients with sarcomatoid mesothelioma or advanced-stage disease may not benefit from aggressive surgery.

Age alone does not disqualify a patient, though older patients are evaluated more carefully for surgical risk. A consultation at a specialized mesothelioma treatment center is essential for an accurate surgical assessment.

Before and After Surgery

Before mesothelioma surgery, patients undergo extensive testing including pulmonary function tests, cardiac evaluation, CT scans, and PET scans. Some patients receive neoadjuvant chemotherapy to shrink tumors before the operation.

Recovery from major mesothelioma surgery typically involves a hospital stay of one to two weeks, followed by several weeks of at-home recovery. After surgery, many patients receive adjuvant chemotherapy or radiation therapy as part of a multimodal treatment plan.

Surgical Outcomes

Surgical outcomes vary based on the procedure, patient characteristics, and the experience of the surgical team. Studies show P/D patients at high-volume centers have median survival of 20–30 months. Peritoneal mesothelioma patients treated with cytoreductive surgery and HIPEC have seen median survival exceeding 50 months in some series.

Research consistently demonstrates that patients treated at high-volume centers by experienced surgeons have better outcomes. The surgeon’s case volume and institutional experience are among the strongest predictors of successful surgical results. Seeking a second opinion at a designated mesothelioma center is always reasonable.

Covering the Cost of Surgery

Mesothelioma surgery can be among the most expensive components of treatment. For patients whose mesothelioma resulted from asbestos exposure, financial compensation may be available through legal claims to help cover these costs. An experienced mesothelioma lawyer can explain your legal options while you focus on treatment.