RT Journal Article
SR Electronic
T1 Predicting survival in malignant pleural mesothelioma using routine clinical and laboratory characteristics
JF BMJ Open Respiratory Research
JO BMJ Open Resp Res
FD British Thoracic Society
SP e000506
DO 10.1136/bmjresp-2019-000506
VO 8
IS 1
A1 Gunatilake, Samal
A1 Lodge, David
A1 Neville, Daniel
A1 Jones, Thomas
A1 Fogg, Carole
A1 Bassett, Paul
A1 Begum, Selina
A1 Kerley, Sumita
A1 Marshall, Laura
A1 Glaysher, Sharon
A1 Elliott, Scott
A1 Stores, Rebecca
A1 Bishop, Lesley
A1 Chauhan, Anoop
YR 2021
UL http://bmjopenrespres.bmj.com/content/8/1/e000506.abstract
AB Introduction The prognosis of malignant pleural mesothelioma (MPM) is poor, with a median survival of 8–12 months. The ability to predict prognosis in MPM would help clinicians to make informed decisions regarding treatment and identify appropriate research opportunities for patients. The aims of this study were to examine associations between clinical and pathological information gathered during routine care, and prognosis of patients with MPM, and to develop a 6-month mortality risk prediction model.Methods A retrospective cohort study of patients diagnosed with MPM at Queen Alexandra Hospital, Portsmouth, UK between December 2009 and September 2013. Multivariate analysis was performed on routinely available histological, clinical and laboratory data to assess the association between different factors and 6-month survival, with significant associations used to create a model to predict the risk of death within 6 months of diagnosis with MPM.Results 100 patients were included in the analysis. Variables significantly associated with patient survival in multivariate analysis were age (HR 1.31, 95% CI 1.09 to 1.56), smoking status (current smoker HR 3.42, 95% CI 1.11 to 4.20), chest pain (HR 2.14, 95% CI 1.23 to 3.72), weight loss (HR 2.13, 95% CI 1.18 to 3.72), platelet count (HR 1.05, 95% CI 1.00 to 1.10), urea (HR 2.73, 95% CI 1.31 to 5.69) and adjusted calcium (HR 1.47, 95% CI 1.10 to 1.94). The resulting risk model had a c-statistic value of 0.76. A Hosmer-Lemeshow test confirmed good calibration of the model against the original dataset.Conclusion Risk of death at 6 months in patients with a confirmed diagnosis of MPM can be predicted using variables readily available in clinical practice. The risk prediction model we have developed may be used to influence treatment decisions in patients with MPM. Further validation of the model requires evaluation of its performance on a separate dataset.