Prognostic value of the lymphocyte-to-monocyte ratio and other inflammatory markers in malignant pleural mesothelioma.

Abdullah Cetin Tanrikulu,Abdurrahman Abakay,Ozlem Abakay,Halil Komek

doi:10.1007/s12199-016-0530-6

Abdullah Cetin Tanrikulu, Abdurrahman Abakay + Show 2 more

Open Access

https://doi.org/10.1007/s12199-016-0530-6

Copy DOI

Abstract

Inflammation plays a role in malignant pleural mesothelioma (MPM) prognosis and symptoms. We investigated the roles of the new and old inflammatory indexes and markers in MPM prognosis. Two hundred and ninety-two MPM patients (167 male and 125 female) were included in this retrospective study. Demographic parameters were collected from the patients' files. Kaplan-Meier curves and multivariate Cox regression analyses were used for the analysis of prognosis. The mean age of the patients was 58.4years. The mean survival time was 14.6±13.0months. Twenty-four potential prognostic factors associated with a poor outcome were calculated in the univariate analysis, and 16 potential prognostic factors were associated with a poor prognosis. These 16 potential prognostic factors were also analyzed in multivariate analysis. Multivariate analysis showed that increased age, stage 3-4 disease, the non-epithelial type, a low Karnofsky performance score, a high white blood cell count, and a low lymphocyte-to-monocyte ratio (LMR) were associated with a poor prognosis. The results of the multivariate analysis showed that a decreased LMR was associated with poor survival. Patients with LMR ≤2.6 had poor survival compared with those with LMR >2.6 (mean 9.6 vs. 17.0months, respectively; p=0.004). LMR is an independent marker of prognosis in patients with MPM and is superior to the other inflammation-based markers. The inexpensive nature and easy reproducibility of the hemogram should encourage the use of the LMR in clinical practice.

Highlights

Malignant pleural mesothelioma (MPM) is a rare aggressive tumor originating from the pleural mesothelium that is associated with poor survival, and there is limited knowledge concerning its natural history [1]
Twenty-four potential prognostic factors associated with a poor outcome were calculated in the univariate analysis, and 16 potential prognostic factors were associated with a poor prognosis
Multivariate analysis showed that increased age, stage 3–4 disease, the non-epithelial type, a low Karnofsky performance score, a high white blood cell count, and a low lymphocyte-to-monocyte ratio (LMR) were associated with a poor prognosis

Summary

Introduction

Malignant pleural mesothelioma (MPM) is a rare aggressive tumor originating from the pleural mesothelium that is associated with poor survival, and there is limited knowledge concerning its natural history [1]. The European Organization for Research and Treatment of Cancer (EORTC) and Cancer and Leukemia Group B (CALGB) devised two prognostic scoring systems for use in patients with mesothelioma [7, 8]. These scoring systems are not routinely used for MPM prognosis because they are time-consuming and require costly equipment. Identification of parameters that are useful, easy, and inexpensive to measure for predicting MPM prognosis is needed These parameters may be useful for estimating the occurrence of malignant mesothelioma (MM) after asbestos exposure and predicting treatment options and results

Objectives

Methods

Results

Conclusion