title: Health-related quality of life and inflammatory markers in malignant pleural mesothelioma.
abstract: OBJECTIVE
  Malignant pleural mesothelioma (MPM) is a highly aggressive and symptomatic disease. We examined the relationship between health-related quality of life (HRQoL) and inflammatory markers, and the prognostic role of HRQoL in MPM patients.
  
  
  METHODS
  MPM patients from two parallel phase II studies (thalidomide alone or thalidomide with chemotherapy) were included. HRQoL was assessed at baseline using the modified Lung Cancer Symptom Scale (LCSS). Baseline inflammatory markers and cytokines were measured. Spearman correlation was used to examine the relationship between inflammatory markers and HRQoL measures. The prognostic value of the HRQoL domains was examined using Cox proportional hazard model.
  
  
  RESULTS
  Sixty-three patients were included: median age 61 years (range 44-79); 82% male; 77% Eastern Cooperative Oncology Group (ECOG) performance status 0-1; 44% epithelial histology subtype. Baseline systemic symptoms of anorexia and fatigue, the summation symptoms of overall symptomatic distress, interference with normal activity and global QoL and the aggregate score of total LCSS score were all associated with elevated neutrophil-to-lymphocyte ratio, C-reactive protein and vascular endothelial growth factor levels at baseline (rho ≥ 0.25; p < 0.05). Baseline anorexia, fatigue, cough, dyspnoea, pain, overall symptomatic distress, interference with normal activity, global QoL and total LCSS score were all significantly related to survival (p < 0.05) after adjusting for established prognostic factors (age, gender, histological subtype and performance status) and treatment effect.
  
  
  CONCLUSIONS
  In conclusion, HRQoL seems to relate to a patient's systemic inflammatory status and is associated with survival in MPM patients.
authors.affiliation: Department of Medical Oncology, Sydney Cancer Centre, Sydney, Australia.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Kao
authors.forename: Janette
authors.initials: J
authors.lastname: Vardy
authors.forename: Rozelle
authors.initials: R
authors.lastname: Harvie
authors.forename: Mark
authors.initials: M
authors.lastname: Chatfield
authors.forename: Nico
authors.initials: N
authors.lastname: van Zandwijk
authors.forename: Stephen
authors.initials: S
authors.lastname: Clarke
authors.forename: Nick
authors.initials: N
authors.lastname: Pavlakis
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D008214:Lymphocytes / Q000378:metabolism; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013792:Thalidomide / Q000008:administration & dosage; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A; D013792:Thalidomide; D002097:C-Reactive Protein