Prognostic factors in patients with pleural mesothelioma: the European Organization for Research and Treatment of Cancer experience.
OBJECTIVE
Identification of prognostic factors in patients with malignant pleural mesothelioma based on prospectively collected international data.


METHODS
From October 1984 to October 1993, 204 eligible adult patients with malignant pleural mesothelioma were entered into five consecutive prospective European Organization for Research and Treatment of Cancer (EORTC) phase II clinical trials designed to assess the efficacy of various anticancer drugs (mitoxantrone, epidoxorubicin, etoposide, and paclitaxel). The Cox model was used to assess 13 factors related to biology and disease history with respect to survival.


RESULTS
The median survival duration was 12.6 months from diagnosis and 8.4 months from trial entry. In the multivariate analysis, poor prognosis was associated with a poor performance status, a high WBC count, a probable/possible histologic diagnosis of mesothelioma, male gender, and having sarcomatous tissue as the histologic subtype. Taking these five factors into consideration, patients were classified into two groups: a good-prognosis group (1-year survival rate, 40%; 95% confidence interval [CI], 30% to 50%) and a poor-prognosis group (1-year survival, 12%; 95% CI, 4% to 20%).


CONCLUSIONS
These results may help to design new clinical trials in pleural mesothelioma by selecting more homogenous groups of patients.
Curran
D
D
European Organization for Research and Treatment of Cancer Data Center, Brussels, Belgium.
Sahmoud
T
T
Therasse
P
P
van Meerbeeck
J
J
Postmus
P E
PE
Giaccone
G
G
D000367:Age Factors; D000704:Analysis of Variance; D017322:Clinical Trials, Phase II as Topic; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008654:Mesothelioma / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D015996:Survival Rate