Doctors consider several factors when determining a patient’s mesothelioma prognosis, or expected health outlook. Some of these factors include age, cancer stage, and mesothelioma cell type.

The current prognostic model for mesothelioma developed by the International Association for the Study of Lung Cancer (IASLC) remains a valuable tool in predicting patient outcomes, according to Dr. Andrea Wolf of the Icahn School of Medicine at Mount Sinai in New York City.

However, during a presentation at the 2023 World Conference on Lung Cancer, Dr. Wolf indicated that there’s room to improve the existing model by looking at other prognostic factors, including anemia and elevated mesothelin levels.

“By refining and validating prognostic models, we are advancing our ability to tailor treatment strategies and improve patient outcomes.”
– Dr. Andrea Wolf, Director of the New York Mesothelioma Program at Mount Sinai Health System

Learn about the factors that may help doctors make a more accurate prognosis and provide more personalized treatment below.

Understanding Prognostic Factors in Pleural Mesothelioma

Pleural mesothelioma is a rare and aggressive cancer of the lung lining caused by asbestos exposure.

Prognostic factors for pleural mesothelioma are essential in determining the course of this disease, survival rate, and life expectancy, all of which make up a prognosis. They help doctors understand the severity of the disease, the potential for it to spread to other areas, and the patient’s overall health.

Some of these prognostic factors include:

  • Gender (men are more commonly affected)
  • Genetic and molecular markers
  • Patient’s age and overall health
  • Rate of tumor growth
  • Tumor size and location within the chest cavity

Prognostic factors also play a vital role in shaping treatment decisions for pleural mesothelioma.

By evaluating these factors, health care providers can tailor mesothelioma treatment to each patient, ensuring they receive the best possible care to improve their prognosis.

Building on What Already We Know

The IASLC has been instrumental in advancing our understanding of pleural mesothelioma. In 2009, it established an international database to enhance the accuracy of disease staging, which is the most important factor for estimating a patient’s mesothelioma prognosis.

Mesothelioma staging is a systematic way of assessing the severity of cancer within the body. It helps doctors understand how advanced the cancer is, if and where it has spread, and how it may affect the patient’s response to treatment.

Staging was largely used as the sole predictor of survival before additional research shed light on other important prognostic factors.

In 2014, the IASLC identified these additional factors for determining prognosis:

  • Age (over 50 vs. younger)
  • Cell type (epithelioid vs. biphasic or sarcomatoid)
  • Complete blood count (platelets, white blood cells, and hemoglobin)
  • Type of surgery (palliative vs. life-extending)
  • Use of chemotherapy or radiotherapy after surgery

What Does the Latest Research Show?

In 2023, Dr. Wolf and her fellow researchers conducted a study using a new cohort of 1,733 patients diagnosed with mesothelioma between 2009 and 2019. They compared data on these patients to the original data collected in 2014 from 3,101 patients.

The results showed the 2014 model, which has been the foundation of mesothelioma prognosis for nearly a decade, remains accurate. More specifically, it serves as a solid baseline for determining someone’s prognosis, but it could be improved to make doctors’ predictions more accurate.

“The IASLC models performed relatively well in this updated validation dataset, but clearly these models have room for improvement.”
– Dr. Andrea Wolf, Director of the New York Mesothelioma Program at Mount Sinai Health System

Dr. Wolf shared that continued efforts to gather and analyze patient data will be key to improving survival predictions and providing individualized patient care.

Her team also found two new predictors of survival in their research, both related to patient blood characteristics.

Identifying Additional Predictors of Survival

Dr. Wolf’s research has introduced two new predictors of survival: anemia (lack of healthy red blood cells) and elevated mesothelin levels.

Mesothelin is a protein that can be detected in blood tests and is sometimes used as a biomarker (indicator of disease) for pleural mesothelioma. It has become a key target for research and new treatment strategies for this cancer.

Pleural mesothelioma patients with anemia and high mesothelin levels had much lower survival rates (which measure the percent of patients still alive at a certain point after diagnosis) than those without, as shown in the chart below.

Patient Group3-Year Survival Rate
Patients With Anemia20%
Patients Without Anemia30%
Patients With High Mesothelin Levels20%
Patients Without HIgh Mesothelin Levels34%

These findings provide hope for the development of more accurate prognosis models and better treatment options for patients with these risk factors.

Get Dedicated Support to Improve Your Prognosis

If you or a loved one has been diagnosed with mesothelioma, Mesothelioma Hope can help you find the best medical care to improve your prognosis. In fact, we have experienced nurses on staff who can connect you with top doctors and hospitals right now.

From accessing treatments to managing medical expenses and finding emotional support, our goal is to make sure you have the resources you need to navigate every aspect of your fight against mesothelioma.

Call (866) 608-8933 now to speak to a Patient Advocate or use our Free Doctor Match service to connect with top specialists for treatment.

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Laura WrightWritten by:

Lead Editor

Laura Wright is a journalist and content strategist with more than 15 years of professional experience. She attended college at the University of Florida, graduating magna cum laude with a bachelor’s degree in journalism in 2008. Her writing has been featured in The Gainesville Sun and other regional publications throughout Florida.

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  1. Cancer Therapy Advisor. (2023). Identifying Prognostic Factors in Pleural Mesothelioma. Retrieved October 30, 2023, from
  2. IASLC. (2023). IASLC staging model for mesothelioma validated; study supports continued use of model. Retrieved October 30, 2023, from
  3. Pass, H. I., Giroux, D., Kennedy, C., et al. (2014). Supplementary Prognostic Variables for Pleural Mesothelioma: A Report from the IASLC Staging Committee. Journal of Thoracic Oncology. Retrieved October 30, 2023, from
  4. Wolf, A., Rosenthal, A., Giroux, D., et al. (2023). The International Association for the Study of Lung Cancer Pleural Mesothelioma Staging Project: Updated Modeling of Prognostic Factors in Pleural Mesothelioma. IASLC. Retrieved October 30, 2023, from

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