Abstract
Objective: To determine prognostic factors in malignant pleural mesothelioma.
Method: Variables analyzed include age at diagnosis, gender, smoking, chest pain, dyspnea, weight loss, platelet count, WBC, hemoglobin, lactate dehydrogenase, histology, stage, KPS, side of diseases, pleural fluid, treatment, talc pleurodesis, and co-morbidities. Overall survival was defined as the time between the initial diagnosis date and either date of death or last follow-up. Univariate analyses of survival in relation to patient’s demographics and tumor characteristics were conducted. The independent contribution to survival of several prognostic factors was analyzed with multivariate regression methods based on the Cox proportional hazards model.
Results: 600 patients with pathologically proven malignant pleural mesothelioma were evaluated between January 1990 and December 2016. 45 patients were excluded. Survival characteristics of 550 patients were evaluated. The mean age of the patients was 61.8±11.4 years for males and 60.1±12.2 for females (p=0.010). A total 54.4% of the cases were male and 45.6% were female. At univariate analysis, predictors of survival were age, gender, weight loss, platelet count, WBC, lactate dehydrogenase, histology, stage, KPS, side of disease, and treatment. At multivariate analysis, independent significant predictors of survival were WBC, histology, stage, KPS, and treatment. WBC≤8600, epiteloid histology, stage I–II, KPS≥80, and bi/trimodal treatment were related good prognosis in mesothelioma.
Conclusion: Mesothelioma patients with epiteloid histology, early stage disease, and good performance status should be encouraged for bi/trimodal treatment.
- Copyright ©the authors 2017