Application of LMLC Prognostic Score in Survival Predicting of Malignant Pleural Effusion Secondary to Pleural Mesothelioma

Abstract

Background: Malignant pleural mesothelioma (MPM) is an aggressive tumor with poor prognosis. Variables to estimate overall survival (OS) for malignant pleural effusion (MPE) secondary to MPM are unidentified, especially the ones in pleural fluid. Methods: Based on the retrospective cohort study of patients diagnosed with MPE secondary to MPM at Tianjin Chest Hospital from January 2019 to January 2022 and Beijing Chaoyang Hospital from January 2013 to January 2022, multivariate analysis was performed on routinely available demographic, clinical, hematological, and pleural fluid data to assess the association between different parameters and OS. Results: We screened 81 patients who met the eligibility criteria. Four routinely available parameters including LDH level in pleural fluid, MPV level, lymphocyte count, and chemotherapy (the LMLC prognostic score) were found to be independent risk variables for the prognosis of MPE secondary to MPM. Patients were divided into two prognosis subgroups based on risk stratification, with median survival periods of 42 and 19 months, respectively. In comparison with the low-risk group, the high-risk groups showed significantly poorer survival (HR 3.713; 95% CI 1.889 - 7.298; P <0.001). Conclusion: In patients with MPE secondary to MPM, the novel prognostic score utilizes pre-treatment parameters obtained from blood and pleural fluid tests and treatment to predict OS. This system can improve stratification on clinical trials and help clinicians and patients to determine the most appropriate treatment.