Skip to main content

Advertisement

SpringerLink
Log in

Stratification of Malignant Pleural Mesothelioma Prognosis Using Recursive Partitioning Analysis

  • Published:
Lung Aims and scope Submit manuscript

Abstract

Purpose

Prognostic factors and complicated prognostic models have been proposed for malignant pleural mesothelioma (MPM). This study was designed to stratify MPM prognosis by using a simple model.

Methods

Patients diagnosed with MPM in the past 10 years (n = 122) were examined retrospectively. Data on the presence of chest pain, performance status (PS), asbestos exposure, smoking status, white blood cell count (WBC), haemoglobin (Hb) concentration, platelet count (PLT), lactate dehydronate (LD), histology, stage, and date of death or censored status were collected. After the factors were examined in the univariate analysis, recursive partitioning analysis was performed.

Results

Statistically significant factors related to survival were the type of histology, stage, PS, WBC, PLT, Hb concentration, and LD. Histology, stage, PS, and Hb concentration were used in multivariate analysis. Stage and Hb concentration showed good statistical significance, whereas PS was borderline significant. The survival analyses were stratified into five groups by PS, stage, Hb concentration, and chest pain using recursive partitioning analysis. Group A comprised patients showing the most favourable prognoses (PS 0–2 and Hb concentration >12.1 g dL−1 or PS 0–2 and Hb concentration ≤12.1 g dL−1 without pain), and group B comprised the remaining patients. The median overall survival in groups A and B was 563 days (95 % confidence interval [CI] 502–779) and 157 days (95 % CI 115–224), respectively (hazard ratio of 5.44 [3.46–8.53, P < 0.0001]).

Conclusions

The MPM patients with PS 0–2 and Hb concentration >12.1 or ≤12.1 g dL−1 without chest pain had favourable prognoses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kanazawa N, Ioka A, Tsukuma H, Ajiki W, Oshima A (2006) Incidence and survival of mesothelioma in Osaka, Japan. Jpn J Clin Oncol 36:254–257

    Article  PubMed  Google Scholar 

  2. Nojiri S, Gemba K, Aoe K, Kato K, Yamaguchi T, Sato T, Kubota K, Kishimoto T (2011) Survival and prognostic factors in malignant pleural mesothelioma: a retrospective study of 314 patients in the west part of Japan. Jpn J Clin Oncol 41:32–39

    Article  PubMed  Google Scholar 

  3. van der Bij S, Koffijberg H, Burgers JA, Baas P, van de Vijver MJ, de Mol BA, Moons KG (2012) Prognosis and prognostic factors of patients with mesothelioma: a population-based study. Br J Cancer 107:161–164

    Article  PubMed Central  PubMed  Google Scholar 

  4. Herndon JE, Green MR, Chahinian AP, Corson JM, Suzuki Y, Vogelzang NJ (1998) Factors predictive of survival among 337 patients with mesothelioma treated between 1984 and 1994 by the Cancer and Leukemia Group B. Chest 113:723–731

    Article  CAS  PubMed  Google Scholar 

  5. Curran D, Sahmoud T, Therasse P, van Meerbeeck J, Postmus PE, Giaccone G (1998) Prognostic factors in patients with pleural mesothelioma: the European Organization for Research and Treatment of Cancer experience. J Clin Oncol 16:145–152

    CAS  PubMed  Google Scholar 

  6. Vogelzang NJ, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, Gatzemeier U, Boyer M, Emri S, Manegold C, Niyikiza C, Paoletti P (2003) Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 21:2636–2644

    Article  CAS  PubMed  Google Scholar 

  7. van Meerbeeck JP, Gaafar R, Manegold C, Van Klaveren RJ, Van Marck EA, Vincent M, Legrand C, Bottomley A, Debruyne C, Giaccone G (2005) Randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an intergroup study of the European Organisation for Research and Treatment of Cancer Lung Cancer Group and the National Cancer Institute of Canada. J Clin Oncol 23:6881–6889

    Article  PubMed  Google Scholar 

  8. Rusch VW (1995) A proposed new international TNM staging system for malignant pleural mesothelioma. From the International Mesothelioma Interest Group. Chest 108:1122–1128

    Article  CAS  PubMed  Google Scholar 

  9. Torsten H, Kurt H, Achim Z (2006) Unbiased recursive partitioning: a conditional inference framework. J Comput Graph Stat 15:651–674

    Article  Google Scholar 

  10. John C, Antje H (2012) Prognostic groups by tree-based partitioning and data refinement methods. In: Handbook of statistics in clinical oncology, 3rd edn. CRC Press, Boca Raton, pp 505–528

  11. Suzuki H, Hirashima T, Kobayashi M, Okamoto N, Matsuura Y, Tamiya M, Morishita N, Okafuji K, Shiroyama T, Morimura O, Morita S, Kawase I (2012) Prognostic factors in malignant pleural mesothelioma: a retrospective study. Intern Med 51:707–710

    Article  PubMed  Google Scholar 

  12. Kindler HL (2012) Robust data: the essential foundation of a revised staging system for pleural mesothelioma. J Thorac Oncol 7:1623–1624

    Article  PubMed  Google Scholar 

  13. Richards WG, Godleski JJ, Yeap BY, Corson JM, Chirieac LR, Zellos L, Mujoomdar A, Jaklitsch MT, Bueno R, Sugarbaker DJ (2010) Proposed adjustments to pathologic staging of epithelial malignant pleural mesothelioma based on analysis of 354 cases. Cancer 116:1510–1517

    Article  PubMed  Google Scholar 

  14. Rusch VW, Giroux D, Kennedy C, Ruffini E, Cangir AK, Rice D, Pass H, Asamura H, Waller D, Edwards J, Weder W, Hoffmann H, van Meerbeeck JP (2012) Initial analysis of the international association for the study of lung cancer mesothelioma database. J Thorac Oncol 7:1631–1639

    Article  PubMed  Google Scholar 

  15. Kao SC, Vardy J, Chatfield M, Corte P, Pavlakis N, Clarke C, van Zandwijk N, Clarke S (2013) Validation of prognostic factors in malignant pleural mesothelioma: a retrospective analysis of data from patients seeking compensation from the New South Wales dust diseases board. Clin Lung Cancer 14:70–77

    Article  PubMed  Google Scholar 

  16. Edwards JG, Abrams KR, Leverment JN, Spyt TJ, Waller DA, O’Byrne KJ (2000) Prognostic factors for malignant mesothelioma in 142 patients: validation of CALGB and EORTC prognostic scoring systems. Thorax 55:731–735

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Fennell DA, Parmar A, Shamash J, Evans MT, Sheaff MT, Sylvester R, Dhaliwal K, Gower N, Steele J, Rudd R (2005) Statistical validation of the EORTC prognostic model for malignant pleural mesothelioma based on three consecutive phase II trials. J Clin Oncol 23:184–189

    Article  PubMed  Google Scholar 

  18. Mineo TC, Ambrogi V (2012) Malignant pleural mesothelioma: factors influencing the prognosis. Oncology (Williston Park) 26:1164–1175

    Google Scholar 

  19. Flores RM, Zakowski M, Venkatraman E, Krug L, Rosenzweig K, Dycoco J, Lee C, Yeoh C, Bains M, Rusch V (2007) Prognostic factors in the treatment of malignant pleural mesothelioma at a large tertiary referral center. J Thorac Oncol 2:957–965

    Article  PubMed  Google Scholar 

  20. Musk AW, Olsen N, Alfonso H, Reid A, Mina R, Franklin P, Sleith J, Hammond N, Threlfall T, Shilkin KB, de Klerk NH (2011) Predicting survival in malignant mesothelioma. Eur Respir J 38:1420–1424

    Article  CAS  PubMed  Google Scholar 

  21. Higashiguchi M, Suzuki H, Hirashima T, Kobayashi M, Goya S, Okamoto N, Matsuura Y, Tamiya M, Morishita N, Tsumori T, Kawase I (2012) A retrospective study of chemotherapy with and without pemetrexed in malignant pleural mesothelioma. Anticancer Res 32:609–613

    CAS  PubMed  Google Scholar 

Download references

Conflict of Interest

None.

Author information

Authors and Affiliations

  1. Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1 Habikino Habikino-shi, Osaka, 583-8588, Japan

    Hidekazu Suzuki, Tomonori Hirashima, Norio Okamoto, Tadahiro Yamadori, Motohiro Tamiya, Naoko Morishita, Takayuki Shiroyama, Sawa Takeoka, Akio Osa, Yuichiro Azuma & Ichiro Kawase

  2. Department of Clinical Oncology, National Hospital Organization Kinki-chuo Chest Medical Center, Osaka, Japan

    Kazuhiro Asami, Kyoichi Okishio, Tomoya Kawaguchi & Shinji Atagi

Authors
  1. Hidekazu Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuhiro Asami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomonori Hirashima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Norio Okamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tadahiro Yamadori
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Motohiro Tamiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Naoko Morishita
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takayuki Shiroyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sawa Takeoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Akio Osa
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Yuichiro Azuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Kyoichi Okishio
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Tomoya Kawaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Shinji Atagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Ichiro Kawase
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hidekazu Suzuki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Suzuki, H., Asami, K., Hirashima, T. et al. Stratification of Malignant Pleural Mesothelioma Prognosis Using Recursive Partitioning Analysis. Lung 192, 191–195 (2014). https://doi.org/10.1007/s00408-013-9516-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-013-9516-y

Keywords

Search

Navigation