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Iser S, Hintermair S, Varga A, Çelik A, Sayan M, Kankoç A, Akyürek N, Öğüt B, Bertoglio P, Capozzi E, Solli P, Ventura L, Waller D, Weber M, Stubenberger E, Ghanim B. Validation of Inflammatory Prognostic Biomarkers in Pleural Mesothelioma. Cancers (Basel) 2023; 16:93. [PMID: 38201520 PMCID: PMC10778470 DOI: 10.3390/cancers16010093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/16/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Evoked from asbestos-induced inflammation, pleural mesothelioma represents a fatal diagnosis. Therapy ranges from nihilism to aggressive multimodality regimens. However, it is still unclear who ultimately benefits from which treatment. We aimed to re-challenge inflammatory-related biomarkers' prognostic value in times of modern immune-oncology and lung-sparing surgery. The biomarkers (leukocytes, hemoglobin, platelets, neutrophils, lymphocytes, monocytes, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP)) and clinical characteristics (age, sex, histology, therapy) of 98 PM patients were correlated to overall survival (OS). The median OS was 19.4 months. Significant OS advantages (Log-Rank) were observed in multimodal treatment vs. others (26.1 vs. 7.2 months, p < 0.001), surgery (pleurectomy/decortication) vs. no surgery (25.5 vs. 3.8 months, p < 0.001), a high hemoglobin level (cut-off 12 g/dL, 15 vs. 24.2 months, p = 0.021), a low platelet count (cut-off 280 G/L, 26.1 vs. 11.7 months, p < 0.001), and a low PLR (cut-off 194.5, 25.5 vs. 12.3 months, p = 0.023). Histology (epithelioid vs. non-epithelioid, p = 0.002), surgery (p = 0.004), CRP (cut-off 1 mg/dL, p = 0.039), and platelets (p = 0.025) were identified as independent prognostic variables for this cohort in multivariate analysis (Cox regression, covariates: age, sex, histology, stage, CRP, platelets). Our data verified the previously shown prognostic role of systemic inflammatory parameters in patients treated with lung-sparing surgery within multimodality therapy.
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Affiliation(s)
- Stephanie Iser
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
| | - Sarah Hintermair
- Department of General and Thoracic Surgery, University Hospital Krems, Mitterweg 10, 3500 Krems, Austria
| | - Alexander Varga
- Department of Pathology, University Hospital Krems, 3500 Krems, Austria
| | - Ali Çelik
- Department of Thoracic Surgery, School of Medicine, Gazi University, Besevler, 06500 Ankara, Turkey
| | - Muhammet Sayan
- Department of Thoracic Surgery, School of Medicine, Gazi University, Besevler, 06500 Ankara, Turkey
| | - Aykut Kankoç
- Department of Thoracic Surgery, School of Medicine, Gazi University, Besevler, 06500 Ankara, Turkey
| | - Nalan Akyürek
- Department of Pathology, School of Medicine, Gazi University, Besevler, 06500 Ankara, Turkey
| | - Betül Öğüt
- Department of Pathology, School of Medicine, Gazi University, Besevler, 06500 Ankara, Turkey
| | - Pietro Bertoglio
- Division of Thoracic Surgery, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Enrico Capozzi
- Division of Thoracic Surgery, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Piergiorgio Solli
- Division of Thoracic Surgery, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy
| | - Luigi Ventura
- Barts Thorax Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BS, UK
- Department of Thoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK
| | - David Waller
- Barts Thorax Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BS, UK
| | - Michael Weber
- Division of Biostatistics and Data Science, Department of General Health Studies, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
| | - Elisabeth Stubenberger
- Department of General and Thoracic Surgery, University Hospital Krems, Mitterweg 10, 3500 Krems, Austria
| | - Bahil Ghanim
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Department of General and Thoracic Surgery, University Hospital Krems, Mitterweg 10, 3500 Krems, Austria
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