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Validation of prognostic factors in malignant pleural mesothelioma: a retrospective analysis of data from patients seeking compensation from the New South Wales Dust Diseases Board.
- Source :
-
Clinical lung cancer [Clin Lung Cancer] 2013 Jan; Vol. 14 (1), pp. 70-7. Date of Electronic Publication: 2012 Jun 01. - Publication Year :
- 2013
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Abstract
- Introduction: We aimed to examine the prognostic values of established risk factors and to validate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in an independent series of patients with malignant pleural mesothelioma (MPM).<br />Patients and Methods: A total of 148 patients who applied for compensation at the Dust Diseases Board from 2007 to 2009 were included in this study. Overall survival was determined by the Kaplan-Meier method, and NLR was defined as the absolute neutrophil divided by the lymphocyte count. The prognostic value of the variables was examined by using Cox regression analysis, and all factors were entered into a multivariate model to determine their independent effect.<br />Results: The patient characteristics were median age of 73 years; 93% men; 59% epithelial subtype; median NLR of 3.5 at diagnosis (n = 79); median overall survival of 10.6 months. The following variables were predictive of longer overall survival in univariate analysis: younger age, epithelial subtype, lower tumor stage, low white cell count, low platelet count, low hemoglobin level, and low NLR. Multivariate analysis confirmed that nonepithelial vs. epithelial subtype (hazard ratio [HR], 3.0; P < .001), tumor stage (HR, 1.6; P < .001), hemoglobin level difference ≥10 vs. <10 (HR, 2.0; P = .03), no chemotherapy vs. use of chemotherapy (HR, 2.4; P < .001), and NLR ≥3 vs. <3 (HR, 2.2; P < .01) were independently associated with prognosis.<br />Conclusions: Apart from previously recognized factors, such as histosubtype, tumor stage, and hemoglobin level difference, NLR, an index of systemic inflammation bears prognostic significance that shows that a snapshot of immune status is able to convey important prognostic information.<br /> (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Female
Hemoglobins metabolism
Humans
Kaplan-Meier Estimate
Lymphocyte Count
Lymphocytes
Male
Mesothelioma drug therapy
Middle Aged
Multivariate Analysis
Neoplasm Staging
Neutrophils
New South Wales
Platelet Count
Pleural Neoplasms drug therapy
Prognosis
Proportional Hazards Models
Retrospective Studies
Mesothelioma pathology
Pleural Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1938-0690
- Volume :
- 14
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Clinical lung cancer
- Publication Type :
- Academic Journal
- Accession number :
- 22658812
- Full Text :
- https://doi.org/10.1016/j.cllc.2012.03.011