Prognostic factors in diffuse malignant pleural mesothelioma: effects of pretreatment clinical and laboratory characteristics

• Published in: Respiratory medicine Vol. 95; no. 10; pp. 829 - 835
• Main Authors: METINTAS, M., METINTAS, S., UCGUN, I., GIBBS, A.R., HARMANCI, E., ALATAS, F., ERGINEL, S., TEL, N., PASAOGLU, O.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-10-2001; Elsevier
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Analysis of Variance; Asbestos; asbestos exposure; Biological and medical sciences; Chest Pain - etiology; Dyspnea - etiology; Environmental Exposure; Female; histopathology; Humans; Lung Neoplasms - complications; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Medical sciences; mesothelioma; Mesothelioma - complications; Mesothelioma - mortality; Mesothelioma - pathology; Middle Aged; Pneumology; Prognosis; Proportional Hazards Models; Regression Analysis; Sex Factors; Smoking - adverse effects; Survival Rate; Time Factors; treatment; Tumors of the respiratory system and mediastinum; Weight Loss; histopathology; treatment; asbestos exposure; mesothelioma; prognosis; Antineoplastic agent; Diffuse; Human; Prognosis; Respiratory disease; Enzyme; Chemical pretreatment; Malignant tumor; Survival; L-Lactate dehydrogenase; Chemotherapy; Malignant mesothelioma; Treatment; Immunotherapy; Pleural disease; Advanced stage; Oxidoreductases; Predictive factor; Age; Pleura
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1053/rmed.2001.1178

The aim of this study was to investigate the effects of various pretreatment clinical and laboratory characteristics on the survival of patients with diffuse malignant pleural mesothelioma (DMPM). One hundred histopathologically confirmed DMPM patients were evaluated. Fifty-nine were treated with chemoimmunotherapy, while 41 who had refused chemoimmunotherapy received supportive therapy alone. The following pretreatment characteristics were evaluated in both univariate and multivariate Cox regression analyses: age, gender, Karnofsky performance score (KPS), histology, asbestos exposure, presence of chest pain, dyspnoea, weight loss, symptom duration, smoking history, disease location, platelet count, haemoglobin, white blood cell (WBC) count, serum lactate dehydrogenase (LDH) and extent of disease (stage). Univariate analysis showed that patients with age ≥75 years, male gender, smoking history, advanced stages above stage I disease, KPS <70, WBC count ≥8450 and LDH level ≥500 IU l−1have a worse prognosis. With multivariate Cox regression analyses, age ≥75 years, advanced stages above stage I disease, KPS <70 and LDH level ≥500 IU l−1were found to be indicators of a poorer prognosis. In conclusion, in our study each of low performance status, older age, advanced stage disease, high LDH level and prognosis were found to be related.