Supplementary Prognostic Variables for Pleural Mesothelioma: A Report from the IASLC Staging Committee
Year: 2014
Type: supplementary-materials
Abstract: INTRODUCTION: The staging system for malignant pleural mesothelioma is controversial. To revise this system, the International Association for the Study of Lung Cancer Staging Committee developed an international database. This report analyzes prognostic variables in a surgical population, which are supplementary to previously published CORE variables (stage, histology, sex, age, and type of procedure). METHODS: Supplementary prognostic variables were studied in three scenarios: (1) all data available, that is, patient pathologically staged and other CORE variables available (2) only clinical staging available along with CORE variables, and (3) only age, sex, histology, and laboratory parameters are known. Survival was analyzed by Kaplan-Meier, prognostic factors by log rank and stepwise Cox regression modeling after elimination of nonsignificant variables. p value less than 0.05 was significant. RESULTS: A total of 2141 patients with best tumor, node, metastasis (TNM) stages (pathologic with/without clinical staging) had nonmissing age, sex, histology, and type of surgical procedure. Three prognostic models were defined. Scenario A (all parameters): best pathologic stage, histology, sex, age, type of surgery, adjuvant treatment, white blood cell count (WBC) (≥15.5 or not), and platelets (≥400 k or not) (n = 550). Scenario B (no surgical staging): clinical stage, histology, sex, age, type of surgery, adjuvant treatment, WBC, hemoglobin (<14.6 or not), and platelets (n = 627). Scenario C (limited data): histology, sex, age, WBC, hemoglobin, and platelets (n = 906). CONCLUSION: Refinement of these models could define not only the appropriate patient preoperatively for best outcomes after cytoreductive surgery but also stratify surgically treated patients after clinical and pathologic staging who do or do not receive adjuvant therapy.
Source: Journal of Thoracic Oncology
Institutions: The University of Sydney, Ankara University, NYU Langone Health, Azienda Ospedaliero Universitaria San Giovanni Battista, University Hospital Zurich, Cancer Research And Biostatistics, University of Turin, New York University, Fred Hutch Cancer Center, Heidelberg University, Northern General Hospital, The University of Texas MD Anderson Cancer Center, National Cancer Center Hospital, Glenfield Hospital, University of Zurich, Ghent University Hospital, Ghent University, Memorial Sloan Kettering Cancer Center
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,100
OpenAlex ID: W2034914142