Prognostic factors in diffuse malignant pleural mesothelioma: effects of pretreatment clinical and laboratory characteristics

The aim of this study was to investigate the effects of various pretreatment clinical and laboratory characteristics on the survival of patients with diffuse malignant pleural mesothelioma (DMPM). One hundred histopathologically confirmed DMPM patients were evaluated. Fifty-nine were treated with chemoimmunotherapy, while 41 who had refused chemoimmunotherapy received supportive therapy alone. The following pretreatment characteristics were evaluated in both univariate and multivariate Cox regression analyses: age, gender, Karnofsky performance score (KPS), histology, asbestos exposure, presence of chest pain, dyspnoea, weight loss, symptom duration, smoking history, disease location, platelet count, haemoglobin, white blood cell (WBC) count, serum lactate dehydrogenase (LDH) and extent of disease (stage). Univariate analysis showed that patients with age greater than or equal to 75 years, male gender, smoking history, advanced stages above stage 1 disease, KPS < 70,WBC count <greater than or equal to>8450 and LDH level greater than or equal to 500 IU l(-1) have a worse prognosis. With multivariate Cox regression analyses, age greater than or equal to 75 years, advanced stages above stage 1 disease, KPS <70 and LDH level <greater than or equal to>500 IU l(-1) were found to be indicators of a poorer prognosis. in conclusion, in our study each of low performance status, older age, advanced stage disease, high LDH level and prognosis were found to be related. (C) 2001 Harcourt Publishers Ltd.