Artikel
Pretreatment serum albumin level is an independent prognostic parameter in patients with malignant pleural mesothelioma
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Veröffentlicht: | 14. Oktober 2013 |
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Gliederung
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Objective: Malignant Pleural Mesothelioma (MPM) is an aggressive malignancy with poor prognosis. Therapeutic decision is challenging and prognostic biomarkers are urgently needed. The aim of the current study was to evaluate the prognostic value of pre-interventional serum albumin (SA) levels in MPM patients.
Methods: A retrospective study analyzing 190 patients with histopathologically verified MPM and complete clinical follow-up diagnosed between 1994 and 2012 at two different institutions was conducted. All SA levels were measured during routine work-up before any diagnostic/therapeutic intervention. The association between SA levels and survival was analyzed using Cox models adjusted for clinical and pathological factors.
Results: 150 males and 40 females with a mean age of 63±10.4 years were included. Main histological subtype was epitheloid (154 patients; 81.1%). Surgery with curative intention was performed in 71 patients (37.4%). Median overall survival for all patients was 13 months (95% confidence interval [CI] 10.6–15.4 months). Cut-off for SA was defined at the clinically significant level of 35 mg/dl. Patients with normal SA (≥35 mg/dl) at the time of diagnosis had a significant better median overall survival (14.8 months, 95%CI 11.7–18) compared to patients with low SA levels (7.3 months, 95%CI 4.5–10.2, hazard ratio [HR] 1.59, p=0.017). In the multivariate survival analysis, SA (p=0.04), treatment modality (multimodality therapy inc. surgery vs. chemo/radiotherapy alone vs. palliative treatment [p=0.014]) and histology (epitheloid vs. non-epitheloid [p<0.001]) were found to be independent prognostic factors.
Conclusion: Pre-interventional SA level is an independent prognostic factor in MPM.