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Prognostic factors in malignant pleural mesothelioma: a retrospective study
Hidekazu Suzuki1, Tomonori Hirashima, Masashi Kobayashi
1Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan. suzukih@opho.jp
Objective:
The incidence of malignant pleural mesothelioma (MPM) in Japan is predicted to increase over the next few decades. Prognostic factors remain unclear although several studies have reported this disease. In this study, we examined the prognostic factors of MPM from single institution practice data and tested the scoring systems of past reports.
Methods:
We retrospectively obtained clinical data from the medical records of patients who were diagnosed with MPM from 1991 to 2010. The European Organization for Research and Treatment of Cancer prognostic score (EPS) was calculated.
Results:
We surveyed the records of 68 patients. Univariate analysis showed that significant prognostic factors were histological type, stage, performance status (PS), chemotherapy, and lactate dehydrogenase (LD). Multivariate analysis identified stage, PS and LD as independent prognostic factors. Low-risk group (EPS ≤1.27) survival was significantly better than that of the high-risk group (EPS >1.27) (17.0 months vs. 8.0 months; p=0.002).
Conclusion:
Stage, PS and LD were demonstrated to be independent prognostic factors. An EPS >1.27 was still considered a poor prognosis indicator in the practice data of MPM.
Insights
Malignant pleural mesothelioma (MPM) prognosis is linked to stage, performance status (PS), and lactate dehydrogenase (LD). A higher European Organization for Research and Treatment of Cancer prognostic score (EPS) indicates a poorer outcome for MPM patients.
Area of Science:
- Oncology
- Pulmonology
- Medical Statistics
Background:
- Malignant pleural mesothelioma (MPM) incidence is rising in Japan.
- Prognostic factors for MPM require further clarification despite existing research.
- This study analyzes prognostic factors using single-institution data.
Purpose of the Study:
- To identify independent prognostic factors for malignant pleural mesothelioma (MPM).
- To evaluate the effectiveness of established scoring systems, like the European Organization for Research and Treatment of Cancer prognostic score (EPS), in predicting MPM outcomes.
- To inform clinical decision-making and patient management strategies for MPM.
Main Methods:
- Retrospective analysis of clinical data from 68 MPM patients diagnosed between 1991 and 2010.
- Calculation of the European Organization for Research and Treatment of Cancer prognostic score (EPS) for each patient.
- Univariate and multivariate analyses to identify significant prognostic factors.
Main Results:
- Histological type, stage, performance status (PS), chemotherapy, and lactate dehydrogenase (LD) were significant in univariate analysis.
- Stage, PS, and LD emerged as independent prognostic factors in multivariate analysis.
- Patients with an EPS ≤1.27 (low-risk) had significantly better survival (17.0 months) than those with EPS >1.27 (high-risk) (8.0 months).
Conclusions:
- Stage, performance status (PS), and lactate dehydrogenase (LD) are confirmed as independent prognostic factors for MPM.
- An EPS >1.27 remains a valid indicator of poor prognosis in MPM.
- These findings support the use of these factors and scores for risk stratification and treatment planning in MPM.
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