title: A clinical, radiographic and laboratory evaluation of prognostic factors in 363 patients with malignant pleural mesothelioma.
abstract: BACKGROUND
  Malignant pleural mesothelioma (MPM) has a poor prognosis.
  
  
  OBJECTIVE
  Only few studies in literature investigated the presence of pleural fluid and radiographic findings for the prognosis of MPM.
  
  
  METHODS
  We retrospectively investigated the hospital charts of 363 MPM patients who were diagnosed from January 1989 to March 2010. Survival time was calculated by the Kaplan-Meier method. Pretreatment clinical, laboratory and radiographic features of each patient at the time of diagnosis were obtained from patients' charts.
  
  
  RESULTS
  The mean age of 363 patients (217 men, 146 women) was 50.6 ± 11.2 years (range 19-85) and the mean survival time was 11.7 ± 8.6 months (range 1-53). Histological types of MPM were epithelial (71.2%), mixed (15.9%) and sarcomatous type (4.9%). The frequency of disease stages were 31.4% for stage 1, 24.2% for stage 2, 28.6% for stage 3 and 15.8% for stage 4. The most frequent symptoms were dyspnea (82.1%), chest pain (68.3%) and weight loss (58.9%). Results of univariate and multivariate analyses revealed that a Karnofsky performance score ≤60, a pleural fluid glucose level ≤40 mg/dl, a C-reactive protein level >50 mg/l, a serum lactate dehydrogenase level >500 U/l, the presence of pleural fluid, pleural thickening >1 cm and a platelet count of >420 × 10(3)/μl were found to be associated with poor prognosis in MPM.
  
  
  CONCLUSIONS
  Our data suggest that low pleural fluid glucose and high C-reactive protein, the presence of pleural fluid and pleural thickening were associated with poor MPM prognosis. Further prospective studies are needed to highlight prognostic factors more clearly.
authors.affiliation: Department of Chest Disease, Dicle University, Diyarbakir, Turkey.
authors.forename: Abdullah Cetin
authors.initials: AC
authors.lastname: Tanrikulu
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Abakay
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Kaplan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Küçüköner
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Palanci
authors.forename: Osman
authors.initials: O
authors.lastname: Evliyaoglu
authors.forename: Cengizhan
authors.initials: C
authors.lastname: Sezgi
authors.forename: Hadice
authors.initials: H
authors.lastname: Sen
authors.forename: Ali İhsan
authors.initials: Aİ
authors.lastname: Carkanat
authors.forename: Gokhan
authors.initials: G
authors.lastname: Kirbas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000401:mortality*; D008875:Middle Aged; D015999:Multivariate Analysis; D016066:Pleural Effusion, Malignant / Q000175:diagnosis* / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult