Mount Sinai Study Backs Lung-Sparing Surgery for Mesothelioma

Researchers find pleurectomy/decortication can be performed safely with low mortality in carefully selected patients.

Published on Feb. 13, 2026

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A new study from the Icahn School of Medicine at Mount Sinai and the Mount Sinai Tisch Cancer Center finds that pleurectomy/decortication, a lung-sparing surgery, can be performed safely with low mortality in carefully selected patients with pleural mesothelioma, a rare and aggressive cancer most often caused by asbestos exposure.

Why it matters

Mesothelioma remains a devastating disease with limited treatment options, making it critical to identify approaches that can safely improve outcomes. This study reinforces that surgery should remain part of the conversation for mesothelioma treatment and can lead to long-term survivorship.

The details

Researchers found zero in-hospital and 30-day mortality, and a 90-day mortality rate of 4.2 percent, substantially lower than rates reported in the MARS2 trial in 2024. The study highlights that outcomes depend not only on whether surgery is performed, but how and in whom. Nearly 80 percent of patients demonstrated the epithelioid subtype of mesothelioma, which is known to respond better to surgical treatment. All patients underwent rigorous preoperative testing, and patients undergoing extrapleural pneumonectomy (a surgery associated with higher risk) were excluded.

  • The research was published in The Annals of Thoracic Surgery in February 2026.
  • The MARS2 trial, which raised concerns about the role of surgery in mesothelioma care, was reported in 2024.

The players

Raja M. Flores, MD

Professor of Surgery at the Icahn School of Medicine at Mount Sinai, Chair of Thoracic Surgery for the Mount Sinai Health System, and corresponding author of the study.

Irving J. Selikoff, MD

A late Mount Sinai physician-scientist who was instrumental in establishing the link between asbestos exposure and mesothelioma, leading to modern asbestos regulations.

Icahn School of Medicine at Mount Sinai

The institution where the study was conducted.

Mount Sinai Tisch Cancer Center

The cancer center where the study was conducted.

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What they’re saying

“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.”

— Raja M. Flores, MD, Professor of Surgery at the Icahn School of Medicine at Mount Sinai, Chair of Thoracic Surgery for the Mount Sinai Health System (The Annals of Thoracic Surgery)

“This study reinforces that surgery should remain part of the conversation for mesothelioma treatment and can lead to long term survivorship.”

— Raja M. Flores, MD, Professor of Surgery at the Icahn School of Medicine at Mount Sinai, Chair of Thoracic Surgery for the Mount Sinai Health System (The Annals of Thoracic Surgery)

“These results offer hope and clarity for patients facing a difficult diagnosis. Surgery is not for everyone, but for the right patients, it can be both safe and meaningful.”

— Raja M. Flores, MD, Professor of Surgery at the Icahn School of Medicine at Mount Sinai, Chair of Thoracic Surgery for the Mount Sinai Health System (The Annals of Thoracic Surgery)

What’s next

The research team is currently expanding this work by studying outcomes associated with combining surgery and immunotherapy for pleural mesothelioma.

The takeaway

This study highlights that with modern imaging, rigorous preoperative evaluation, and careful surgical planning, lung-sparing surgery can be a safe and effective option for carefully selected mesothelioma patients, offering hope in the face of this devastating disease.