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Prognostic value of pleural fluid pH in malignant epithelial mesothelioma after talc poudrage

Yossef Aelony1, Janis F Yao, Randel R King

  • 1Department of Internal Medicine, Kaiser Permanente Medical Center, Harbor City, Calif. 90275, USA. y.aelony@cox.net

Respiration; International Review of Thoracic Diseases
|May 9, 2006
PubMed
Abstract

Insights

Pleural fluid pH (ppH) can predict survival in malignant mesothelioma patients. A baseline ppH of 7.32 or higher indicates a significantly longer survival for those undergoing talc pleurodesis.

Area of Science:

  • Oncology
  • Pulmonary Medicine
  • Diagnostic Medicine

Background:

  • Current staging for malignant mesothelioma is insufficient.
  • Invasive staging methods like pneumonectomy carry significant risks.
  • Pleural fluid pH (ppH) shows prognostic value in other pleural effusions.

Purpose of the Study:

  • To assess if baseline pleural fluid pH correlates with survival in malignant epithelial pleural mesothelioma.
  • To explore the utility of a noninvasive biomarker for mesothelioma prognostication.

Main Methods:

  • Retrospective analysis of 26 malignant epithelial pleural mesothelioma patients treated with thoracoscopic talc pleurodesis.
  • Correlation of baseline pleural fluid pH (ppH) with survival data.
  • Statistical analysis using Cox proportional hazards models to identify significant ppH cutoffs.

Main Results:

  • Mean follow-up was 19 months; 25 of 26 patients died.
  • Median pleural fluid pH was 7.32.
  • Patients with ppH > 7.32 had a median survival of 21.2 months vs. 13.4 months for those with ppH ≤ 7.32 (p=0.0194).

Conclusions:

  • Baseline pleural fluid pH is a significant predictor of survival in malignant mesothelioma patients.
  • This noninvasive test (ppH) should be incorporated into mesothelioma staging.
  • ppH offers a valuable prognostic tool for palliative treatment strategies.

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