Abstract

INTRODUCTION

Malignant mesothelioma (MM) is rare with poor prognosis and often diagnosed at advanced stage. Systemic inflammatory indices (SII) may have prognostic value in cancer. Albumin is a negative acute phase reactant. We evaluated the prognostic significance of SII and albumin to globulin ratio (AGR) in MM followed-up at a single institute

METHODS

Fifty-six MM patients who met the inclusion criteria at our oncology cenrter were included in the study. Patients aged over 18 years with pathologically confirmed malignant pleural and peritoneal mesothelioma and no secondary malignancy followed up at our center were included in the study. Laboratory parameters for estimation of SII and AGR at diagnosis were obtained from database. Those with active infection, which might affect these parameters, those with a medical history of steroid use were excluded from the study.

RESULTS

Median follow-up was 13.5 months. Most of the patients were female (58.9%). Median overall survival (OS) was 13 months. Median OS was 16 months in the pleural mesothelioma group and 9 months in the peritoneal mesothelioma group (p=0.982).OS was negatively correlated with platelet count, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) (p1=0.015, p2=0.009 p3=0.004;respectively).On the other hand, OS was positively correlated with lymphocyte count, albumin and AGR (p1=0.032, p2<0.001, p3=0.004; respectively). Median OS was 22 months in patients with higher albumin level ( >3.5 g/dL) while it was 9 months in others with lower albumin level ( ≤3.5 g/dL), respectively (p=0.03). In multivariate Cox regression analysis, platelet count, lymphocyte count, NLR, PLR, albumin and AGR were determined as independent prognostic factors for OS (p1<0.001, p2=0.001, p3=0.026, p4<0.001, p5=0.03, p6=0.008;respectively)

DISCUSSION AND CONCLUSION

It has been demonstrated that albumin, AGR, NLR, PLR, platelet and lymphocyte counts are independent prognostic factors for OS in MM.