Malignant pleural mesothelioma is the most common type of malignant mesothelioma. Many factors may be involved in determining the survival rate for this aggressive cancer; some are better understood than others. Estimates of median survival time range from one to two years; survival depends on underlying factors such as the type and extent of spread of the mesothelioma. Only seven percent of people with this cancer survive to five years after diagnosis, but this outlook is gradually improving with some promising experimental treatments. Some people live well beyond five years from the time of diagnosis.

In general, younger age at diagnosis, absence of weight loss and limited loss of lung function are associated with chances for increased survival. Stage I mesotheliomas, which have not spread to the lymph nodes or adjacent tissues and organs, also carry the best prognosis. The type of cell the cancer is comprised of can also affect survival. The epithelioid cell type has the best prognosis, the mixed or biphasic cell type the next best prognosis, and the sarcomatoid cell type the worst prognosis. The majority of malignant pleural mesotheliomas are of the epithelioid cell type.

Because this cancer takes so long to manifest, people are usually diagnosed at an older age and with more advanced disease, potentially worsening the prognosis and the treatment options available. The more aggressive the treatment, the better the outcome may be, but in cases with cancer that has spread to other parts of the body, chemotherapy may be the only alternative. New drugs, such as the combination of Alimta with Platinol, have been shown to improve survival in malignant mesothelioma patients whose only option is chemotherapy. A number of experimental treatments, such as immunotherapy and biotherapy, are currently being evaluated in clinical trials.