Supplementary prognostic variables for pleural mesothelioma

A report from the IASLC staging committee

Harvey I. Pass, Dorothy Giroux, Catherine Kennedy, Enrico Ruffini, Ayten K. Cangir, David Rice, Hisao Asamura, David Waller, John Edwards, Walter Weder, Hans Hoffmann, Jan P. Van Meerbeeck, Valerie W. Rusch

Research output: Contribution to journalArticle

39 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)856-864
Number of pages9
JournalJournal of Thoracic Oncology
Volume9
Issue number6
DOIs
Publication statusPublished - 2014
Externally publishedYes

Fingerprint

Mesothelioma
Histology
Leukocyte Count
Blood Platelets
Hemoglobins
Therapeutics
Databases
Neoplasm Metastasis
Survival
Population
Neoplasms

Keywords

  • Mesothelioma
  • Prognosis
  • Registry
  • Staging
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Pass, H. I., Giroux, D., Kennedy, C., Ruffini, E., Cangir, A. K., Rice, D., ... Rusch, V. W. (2014). Supplementary prognostic variables for pleural mesothelioma: A report from the IASLC staging committee. Journal of Thoracic Oncology, 9(6), 856-864. https://doi.org/10.1097/JTO.0000000000000181

Supplementary prognostic variables for pleural mesothelioma : A report from the IASLC staging committee. / Pass, Harvey I.; Giroux, Dorothy; Kennedy, Catherine; Ruffini, Enrico; Cangir, Ayten K.; Rice, David; Asamura, Hisao; Waller, David; Edwards, John; Weder, Walter; Hoffmann, Hans; Van Meerbeeck, Jan P.; Rusch, Valerie W.

In: Journal of Thoracic Oncology, Vol. 9, No. 6, 2014, p. 856-864.

Research output: Contribution to journalArticle

Pass, HI, Giroux, D, Kennedy, C, Ruffini, E, Cangir, AK, Rice, D, Asamura, H, Waller, D, Edwards, J, Weder, W, Hoffmann, H, Van Meerbeeck, JP & Rusch, VW 2014, 'Supplementary prognostic variables for pleural mesothelioma: A report from the IASLC staging committee', Journal of Thoracic Oncology, vol. 9, no. 6, pp. 856-864. https://doi.org/10.1097/JTO.0000000000000181
Pass, Harvey I. ; Giroux, Dorothy ; Kennedy, Catherine ; Ruffini, Enrico ; Cangir, Ayten K. ; Rice, David ; Asamura, Hisao ; Waller, David ; Edwards, John ; Weder, Walter ; Hoffmann, Hans ; Van Meerbeeck, Jan P. ; Rusch, Valerie W. / Supplementary prognostic variables for pleural mesothelioma : A report from the IASLC staging committee. In: Journal of Thoracic Oncology. 2014 ; Vol. 9, No. 6. pp. 856-864.
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T2 - A report from the IASLC staging committee

AU - Pass, Harvey I.

AU - Giroux, Dorothy

AU - Kennedy, Catherine

AU - Ruffini, Enrico

AU - Cangir, Ayten K.

AU - Rice, David

AU - Asamura, Hisao

AU - Waller, David

AU - Edwards, John

AU - Weder, Walter

AU - Hoffmann, Hans

AU - Van Meerbeeck, Jan P.

AU - Rusch, Valerie W.

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N2 - 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.

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KW - Prognosis

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