Could a geometric diagram hold the key to predicting the treatment outcomes of patients with malignant pleural mesothelioma?
A team of thoracic surgery experts at China’s Fudan University believe the answer is yes.
The team has developed such a diagram, called a nomogram, and used it to demonstrate the connection between a list of prognostic factors and actual mesothelioma survival.
Predicting Mesothelioma Prognosis
The new nomogram, recently published in the World Journal of Surgery, uses information on malignant mesothelioma treatments and outcomes from the Surveillance, Epidemiology, and End Results (SEER) database to offer a prediction model for overall mesothelioma survival.
To build it, researchers analyzed the prognostic value of a long list of variables including age, gender, race, year of diagnosis, laterality, histology, and mesothelioma tumor stage. They also considered whether or not a patient had undergone mesothelioma surgery, chemotherapy, or radiotherapy.
Building the Mesothelioma Outcome Prediction Tool
A total of 1,092 mesothelioma cases that met the inclusion criteria were included in the study. Forty-five percent of these mesothelioma patients survived for one year, 23 percent survived for two, and 12.1 percent were still living three years after their mesothelioma diagnosis.
“Cox regression analysis showed that age, race, histology type, T stage, M stage, TNM stage, cancer-directed surgery, and chemotherapy were all independent prognostic factors of malignant pleural mesothelioma patients,” writes study author Shuai Wang who helped develop the nomogram.
When predictions based on the nomogram were tested against actual treatment results, the team found that it had “sufficient discriminatory power” and accurately predicted the clinical outcomes of patients with malignant pleural mesothelioma, based on their individual characteristics.
The Value of Mesothelioma Prognosis
Mesothelioma prognosis is about more than just predicting a patient’s odds of survival. Clinicians use prognostic tools to guide them in their choice of mesothelioma treatments. Patients may rely on prognosis to help them make important therapy, quality of life, and even financial decisions.
Some other suggested prognostic indicators in people with malignant mesothelioma include the ratio of neutrophils to lymphocytes (a measure of inflammation), PET/CT analysis of the tumor’s metabolic rate, the presence or absence of the BAP1 tumor-suppressing gene, CTLA-4 protein levels, and platelet count.
Wang, S, et al, “A Nomogram to Predict Prognosis in Malignant Pleural Mesothelioma”, December 28, 2017, World Journal of Surgery, Epub ahead of print