A mesothelioma diagnosis has always forced patients and families to make difficult decisions. Now, one of the biggest questions in mesothelioma care is once again under debate: Does mesothelioma surgery help, or can it do more harm than good?
In 2024, the MARS2 trial for mesothelioma found that patients who received chemotherapy alone lived longer, while those who had surgery experienced more serious side effects.
But newer research suggests the conversation isn’t that simple. In 2026, Mount Sinai researchers reported better surgical outcomes and survival rates among mesothelioma patients treated at experienced cancer centers. Their findings suggest that carefully selected patients may still benefit from surgery.
Now, surgical experts are asking whether surgery for pleural mesothelioma is becoming a relic of the past or if the story is more nuanced.
For patients navigating treatment, these developments matter. Mesothelioma care isn’t one-size-fits-all, and personalized treatment plans can help ensure you get care tailored to your needs.
What Is the MARS2 Trial for Mesothelioma?
The Mesothelioma and Radical Surgery 2 (MARS2) trial was a large, phase III clinical study designed to determine whether adding lung-sparing surgery to chemotherapy improved survival in patients with pleural mesothelioma.
Conducted across multiple hospitals in the United Kingdom, the trial randomly assigned patients to receive either chemotherapy alone or chemotherapy plus extended pleurectomy with decortication (P/D). Its main goal was to measure overall survival and track serious surgical complications.
Here are the key takeaways from the MARS2 study for mesothelioma:
- Patients who had chemotherapy lived longer than those who got P/D surgery and chemo.
- Patients who underwent P/D surgery experienced higher rates of serious complications and side effects.
- Routine use of extensive mesothelioma surgery may not benefit all patients.
- Only certain patients respond well to surgery for mesothelioma.
These findings sparked debate as to how helpful mesothelioma surgery is for patients. The latest studies offer data to challenge the findings of the MARS2 trial for mesothelioma, adding evidence that shows surgery may help more people than currently believed.
Use our Free Doctor Match service to connect with experienced mesothelioma surgeons and cancer centers based on your diagnosis and location.
What Did the Latest Study Find About MARS2 and Mesothelioma Surgery?
A 2026 study by doctors at Icahn School of Medicine at Mount Sinai Hospital examined P/D surgery outcomes in carefully selected patients.
The authors argued that earlier studies like MARS2 may have overestimated surgical risk because they included patients with more advanced disease, less strict selection criteria, or centers with less experience.
Researchers found that lung-sparing P/D surgery was remarkably safe:
- There were no in-hospital or 30-day deaths.
- The 90-day mortality rate was just 4.2%.
- Experienced cancer centers had better results.
- Careful screening and modern imaging improved outcomes.
- Nearly 80% of patients had the epithelioid cell type, which is more responsive to surgery.
- Surgery can still be an option for some mesothelioma patients when done under the right conditions.
Together, the findings underscore that lung-sparing surgery should be considered as part of a tailored approach rather than being dismissed outright.
While MARS2 suggests chemotherapy alone may offer better outcomes for many patients, experts emphasize that individual factors, such as tumor type, patient health, and the experience of the surgical team, remain critical when deciding if surgery should be part of their treatment plan.
“Our findings show that pleurectomy/decortication can be done safely when patients are carefully selected and surgery is tailored to balance tumor removal with the patient’s ability to tolerate aggressive treatment. This study highlights that outcomes depend not only on whether surgery is performed, but how and in whom.”
Get Help Making Sense of Mesothelioma Treatment
After a mesothelioma diagnosis, it’s important to consider all treatment options, including surgery. Although surgery can be intimidating, research shows it can be safe for some patients when performed by experienced specialists.
At Mesothelioma Hope, we have helped thousands of mesothelioma patients and their families understand their diagnosis, find experienced doctors near them, and get compensation to help pay for medical care.
“Getting diagnosed with a rare cancer is life-changing. I want patients to know they can take control of their journey with mesothelioma, and that we’ll be there with them every step of the way.”
Contact us now to find experienced mesothelioma specialists in your area. We’re here 24/7 to help answer your questions and provide step-by-step guidance.
