Stratification of Malignant Pleural Mesothelioma Prognosis Using Recursive Partitioning Analysis

Suzuki, Hidekazu; Asami, Kazuhiro; Hirashima, Tomonori; Okamoto, Norio; Yamadori, Tadahiro; Tamiya, Motohiro; Morishita, Naoko; Shiroyama, Takayuki; Takeoka, Sawa; Osa, Akio; Azuma, Yuichiro; Okishio, Kyoichi; Kawaguchi, Tomoya; Atagi, Shinji; Kawase, Ichiro

doi:10.1007/s00408-013-9516-y

Cited by 10 publications

(9 citation statements)

References 18 publications

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“…Each of the RPA classes exhibited approximately 10% discrepancy in the 5-year OS (and CSS) compared with neighboring RPA classes. Although risk group definition based on RPA has been widely accepted and adopted to predict the outcomes of several benign and malignant diseases 10 , 14 , 17 – 19 , it is still not commonly used in the field of breast cancer care. A possible reason is that most surgeons, especially breast cancer surgeons, are not acquainted with this simple method although it requires statistical software to perform the cumbersome calculations.…”

Section: Discussionmentioning

confidence: 99%

“…The visually succinct expression of RPA allows the easy and quick understanding of a complicated prognostic model. 14 Displaying the information in a decision tree model allows readers to understand the importance of specific factors and relationships of factor interaction at a first glance. For example, our results showed that LNR was the most important in this model, followed by ER status.…”

Section: Discussionmentioning

confidence: 99%

“…Many health care studies have employed RPA to explore prognostic factors and risk groups, including those related to breast cancer in just a few cases. 12 – 14 …”

Section: Introductionmentioning

confidence: 99%

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Recursive Partitioning Analysis of Lymph Node Ratio in Breast Cancer Patients

et al. 2015

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Lymph node ratio (LNR) is a powerful prognostic factor for breast cancer. We conducted a recursive partitioning analysis (RPA) of the LNR to identify the prognostic risk groups in breast cancer patients. Records of newly diagnosed breast cancer patients between 2002 and 2006 were searched in the Taiwan Cancer Database. The end of follow-up was December 31, 2009. We excluded patients with distant metastases, inflammatory breast cancer, survival <1 month, no mastectomy, or missing lymph node status. Primary outcome was 5-year overall survival (OS). For univariate significant predictors, RPA were used to determine the risk groups. Among the 11,349 eligible patients, we identified 4 prognostic factors (including LNR) for survival, resulting in 8 terminal nodes. The LNR cutoffs were 0.038, 0.259, and 0.738, which divided LNR into 4 categories: very low (LNR ≤ 0.038), low (0.038 < LNR ≤ 0.259), moderate (0.259 < LNR ≤ 0.738), and high (0.738 < LNR). Then, 4 risk groups were determined as follows: Class 1 (very low risk, 8,265 patients), Class 2 (low risk, 1,901 patients), Class 3 (moderate risk, 274 patients), and Class 4 (high risk, 900 patients). The 5-year OS for Class 1, 2, 3, and 4 were 93.2%, 83.1%, 72.3%, and 56.9%, respectively (P< 0.001). The hazard ratio of death was 2.70, 4.52, and 8.59 (95% confidence interval 2.32–3.13, 3.49–5.86, and 7.48–9.88, respectively) times for Class 2, 3, and 4 compared with Class 1 (P < 0.001). In conclusion, we identified the optimal cutoff LNR values based on RPA and determined the related risk groups, which successfully predict 5-year OS in breast cancer patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Recursive Partitioning Analysis of Lymph Node Ratio in Breast Cancer Patients

et al. 2015

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“…32 Other research has identified performance status, hemoglobin level, and absence of chest pain as important prognostic features. 33 Following diagnosis of this aggressive life-threatening disease, the information must be sensitively communicated to the patient. Effective communication requires that patients be prepared for the information by having family members or significant others present, tailoring information in a clear, understandable, and honest manner, ensuring privacy and adequate time, offering support, encouraging expression of feelings and concerns, and involving the patient in decision making and the treatment plan.…”

Section: Disease Presentation and Diagnosismentioning

confidence: 99%

Pleural mesothelioma: management updates and nursing initiatives to improve patient care

Lehto

2014

NRR

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Malignant pleural mesothelioma is a relatively rare but aggressive malignancy that is primarily associated with occupational asbestos exposure. While treatment options for mesothelioma have expanded, the disease carries a poor prognosis, with a median of 8 months to 1 year of survival postdiagnosis. This article synthesizes current disease-management practices, including the diagnostic workup, treatment modalities, emerging therapies, and symptom management, and identifies comprehensive nursing strategies that result in the best care based on updated evidence. Multidisciplinary coordination, palliative care initiation, survivorship, and end-of-life care are discussed. Findings may be applied in clinical environments as a resource to help nurses better understand treatment options and care for patients facing malignant pleural mesothelioma. Recommendations for future research are made to move nursing science forward and to improve patient well-being and health-related quality-of-life outcomes for patients and their family members.

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“…Diffuse MM (DMM) is an extremely aggressive neoplasia characterized by a high local diffusion rate, with early involvement of the pericardium and the diaphragm, and by high recurrence rates after radical surgical treatment . Median survival time from diagnosis without treatment ranges from 4 to 12 months; nevertheless better results have been reported in patients with favorable biological and clinical parameters, undergoing a multidisciplinary treatment …”

Section: Introductionmentioning

confidence: 99%

Deciduoid mesothelioma of the thorax: A comprehensive review of the scientific literature

Paliogiannis

Putzu

Ginesu

et al. 2017

Clinical Respiratory J

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Objective: Deciduoid mesothelioma is a rare variant of malignant epithelioid mesothelioma. It often involves the peritoneum, but also thoracic cases have been reported. The aim of the present review is to describe the demographic, clinical, radiological, and pathological features of such a rare variant of thoracic mesothelioma, and the state of the art regarding the therapeutic approaches currently available.Data source: English-language articles published from 1985 to June 2016, and related to thoracic deciduoid mesothelioma cases were retrieved using the Pubmed database.Study selection: The search terms were "mesothelioma," "thoracic mesothelioma," "epithelial mesothelioma," "pleural mesothelioma," and "deciduoid mesothelioma."Results: Forty-four cases included in 16 articles, published in the period under investigation, were analyzed in detail.Conclusions: The mean age of the patients was 63 years, and the male to female ratio 1.7:1. Approximately 58% had exposure to asbestos, and 73% had a smoking history; familiarity was rarely reported. The most common anatomical site of origin was the right pleura, and the most frequent clinical manifestations were chest pain, dyspnea, cough, and weight loss. Thoracic X-ray and computed tomography were the imaging techniques most employed for diagnosis and surgical planning. The pathological diagnosis was obtained by examination of surgical or biopsy specimens in most cases. The best treatment strategy of deciduoid mesothelioma is a matter of debate; nevertheless a multidisciplinary approach is currently the best option for the choice of the adequate therapeutic scheme.cancer, deciduoid, mesothelioma, pleura, thorax | I NTR ODU CTI ONMalignant mesothelioma (MM) is a rare form of cancer derived from mesothelial cells of serous membranes, principally the pleura and the peritoneum.1,2 In most industrialized countries, more than 80% of pleural mesotheliomas in men are related, principally for occupational reasons, to asbestos exposure, particularly to amosite and crocidolite fibres.3 Actually, high incidence rates are observed in western countries as a result of asbestos exposure in the 70s848 |

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Stratification of Malignant Pleural Mesothelioma Prognosis Using Recursive Partitioning Analysis

Abstract: The MPM patients with PS 0-2 and Hb concentration >12.1 or ≤12.1 g dL(-1) without chest pain had favourable prognoses.

Cited by 10 publications

References 18 publications

Recursive Partitioning Analysis of Lymph Node Ratio in Breast Cancer Patients

Recursive Partitioning Analysis of Lymph Node Ratio in Breast Cancer Patients

Pleural mesothelioma: management updates and nursing initiatives to improve patient care

Deciduoid mesothelioma of the thorax: A comprehensive review of the scientific literature

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