A multicentric analysis of prognostic factors in malignant pleural mesothelioma

Authors

  • Mafalda Batista Serviço de Pneumologia, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal; Faculdade de Ciências da Saúde da Universidade da Beira Interior, Covilhã, Portugal https://orcid.org/0000-0002-0426-5941
  • Juliana Barata Serviço de Pneumologia, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal https://orcid.org/0000-0001-8025-6943
  • Sara Costa-Martins Serviço de Pneumologia, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal https://orcid.org/0000-0002-8216-5452
  • Maria Jesus Valente Serviço de Pneumologia, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal https://orcid.org/0000-0002-8973-1373
  • Maria Gabriela Oliveira Fernandes Serviço de Pneumologia, Centro Hospitalar Universitário São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; i3S – Institute for Research and Innovation in Health, Porto, Portugal https://orcid.org/0000-0002-3549-0770
  • Sandra Saleiro Serviço de Pneumologia, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal https://orcid.org/0000-0002-9060-8321
  • Madalena Souto Moura Serviço de Anatomia patológica, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal https://orcid.org/0000-0001-6020-5188
  • Conceição Souto Moura Serviço de Anatomia patológica, Centro Hospitalar Universitário São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  • Adriana Magalhães Serviço de Pneumologia, Centro Hospitalar Universitário São João, Porto, Portugal
  • Maria Salete Valente Serviço de Pneumologia, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal https://orcid.org/0000-0001-9281-2003

DOI:

https://doi.org/10.32932/gecp.2022.02.019

Keywords:

Malignant mesothelioma, pleural tumours, prognosis, survival analysis, asbestos

Abstract

Background: Malignant pleural mesothelioma is a rare entity with poor prognosis, linked to previous asbestos exposure. The main goal of this study was to analyse the impact of clinical factors on mesothelioma prognosis.
Methods: Retrospective cohort study of patients with malignant pleural mesothelioma in three Portuguese institutions, from 1999 to 2020. Statistical analysis was performed with Kaplan–Meier method and Cox regression using IBM SPSS® v25.
Results: 60 patients were included, with male predominance (70%) and a median age of 69 years old. At diagnosis, 61% had advanced TNM stage (TNM III-IV) and 18% had an ECOG-PS ≥ 2. Asbestos exposure was stated in 48%. Epithelioid mesothelioma was the most prevalent histological subtype (81%). The majority received first line chemotherapy, in 10% combined with surgery, and two patients received immunotherapy after progression. Median overall survival (OS) was 13 months and median progression free survival was 10 months. A lower OS was observed in patients with ECOG-PS ≥ 2, age ≥ 70 years, TNM stage III-IV, anaemia, and hypoalbuminemia. Applying the decision tree model proposed by Brims et al. in our population, a significant difference in median OS was observed between the risk groups. In a multivariate analysis using Cox regression, Brims risk group 4, older age and advanced TNM stage were identified as independent negative prognostic factors.
Conclusion: Recognition of these prognostic factors at diagnosis and use of specific prognostic models can help guide malignant pleural mesothelioma management.

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Published

2024-12-28

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Vol. 18 No. 2 (2021)

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