A clinical, radiographic and laboratory evaluation of prognostic factors in 363 patients with malignant pleural mesothelioma.

摘要

BACKGROUND: Malignant pleural mesothelioma (MPM) has a poor prognosis. OBJECTIVES: Only few studies in literature investigated the presence of pleural fluid and radiographic findings for the prognosis of MPM. METHODS: We retrospectively investigated the hospital charts of 363 MPM patients who were diagnosed from January 1989 to March 2010. Survival time was calculated by the Kaplan-Meier method. Pretreatment clinical, laboratory and radiographic features of each patient at the time of diagnosis were obtained from patients' charts. RESULTS: The mean age of 363 patients (217 men, 146 women) was 50.6 +/- 11.2 years (range 19-85) and the mean survival time was 11.7 +/- 8.6 months (range 1-53). Histological types of MPM were epithelial (71.2%), mixed (15.9%) and sarcomatous type (4.9%). The frequency of disease stages were 31.4% for stage 1, 24.2% for stage 2, 28.6% for stage 3 and 15.8% for stage 4. The most frequent symptoms were dyspnea (82.1%), chest pain (68.3%) and weight loss (58.9%). Results of univariate and multivariate analyses revealed that a Karnofsky performance score 50 mg/l, a serum lactate dehydrogenase level >500 U/l, the presence of pleural fluid, pleural thickening >1 cm and a platelet count of >420 x 10(3)/mul were found to be associated with poor prognosis in MPM. CONCLUSIONS: Our data suggest that low pleural fluid glucose and high C-reactive protein, the presence of pleural fluid and pleural thickening were associated with poor MPM prognosis. Further prospective studies are needed to highlight prognostic factors more clearly.