Prognostic factors for malignant mesothelioma in 142 patients : validation of CALGB and EORTC prognostic scoring systems

Edwards, J.G., Abrams, K.R., Leverment, JN., Spyt, T.J., Waller, D.A., & O'Byrne, K.J. (2000) Prognostic factors for malignant mesothelioma in 142 patients : validation of CALGB and EORTC prognostic scoring systems. Thorax, 55(9), pp. 731-735.

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Abstract

Background

The incidence of malignant mesothelioma is increasing. There is the perception that survival is worse in the UK than in other countries. However, it is important to compare survival in different series based on accurate prognostic data. The European Organisation for Research and Treatment of Cancer (EORTC) and the Cancer and Leukaemia Group B (CALGB) have recently published prognostic scoring systems. We have assessed the prognostic variables, validated the EORTC and CALGB prognostic groups, and evaluated survival in a series of 142 patients.

Methods

Case notes of 142 consecutive patients presenting in Leicester since 1988 were reviewed. Univariate analysis of prognostic variables was performed using a Cox proportional hazards regression model. Statistically significant variables were analysed further in a forward, stepwise multivariate model. EORTC and CALGB prognostic groups were derived, Kaplan-Meier survival curves plotted, and survival rates were calculated from life tables.

Results

Significant poor prognostic factors in univariate analysis included male sex, older age, weight loss, chest pain, poor performance status, low haemoglobin, leukocytosis, thrombocytosis, and non-epithelial cell type (p<0.05). The prognostic significance of cell type, haemoglobin, white cell count, performance status, and sex were retained in the multivariate model. Overall median survival was 5.9 (range 0-34.3) months. One and two year survival rates were 21.3% (95% CI 13.9 to 28.7) and 3.5% (0 to 8.5), respectively. Median, one, and two year survival data within prognostic groups in Leicester were equivalent to the EORTC and CALGB series. Survival curves were successfully stratified by the prognostic groups.

Conclusions

This study validates the EORTC and CALGB prognostic scoring systems which should be used both in the assessment of survival data of series in different countries and in the stratification of patients into randomised clinical studies.

Impact and interest:

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164 citations in Web of Science®

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ID Code: 64972
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Malignant mesothelioma, Prognosis, Staging, adult, article, cancer incidence, cancer staging, cancer survival, female, human, life table, major clinical study, male, mesothelioma, priority journal, scoring system, Aged, Aged, 80 and over, England, Humans, Middle Aged, Proportional Hazards Models, Reproducibility of Results, Risk Factors, Survival Analysis, Survival Rate
DOI: 10.1136/thorax.55.9.731
ISSN: 0040-6376
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2000 B M J Group
Deposited On: 02 Dec 2013 06:31
Last Modified: 03 Feb 2015 03:00

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