Survival analysis and development of a prognostic nomogram for patients with malignant mesothelioma in different anatomic sites

Abstract

BackgroundMalignant mesothelioma (MMe) is a rare and fatal cancer with a poor prognosis. Our study aimed to compare the overall survival (OS) of MMe patients across various sites and develop a prognostic model to provide a foundation for individualized management of MMe patients.MethodsFrom the Surveillance, Epidemiology, and End Results (SEER) database, 1,772 individuals with malignant mesothelioma (MMe) were identified. The X-tile software was used to identify the optimal cut-off point for continuous variables. The Kaplan–Meier method was employed to compare the survival of MMe across different sites. The Cox proportional hazards model was applied to identify the independent risk factors of overall survival (OS) and a nomogram was constructed.ResultsIn the survival analysis, MMe originating from the reproductive organs and hollow organs showed a relatively better prognosis than those originating from soft tissue, solid organs, and pleura. Age, gender, location, histological type, grade of differentiation, extent of disease, lymph node status, lymph node ratio (LNR), and chemotherapy were all found to be independent risk variables for the prognosis of MMe patients (P<0.05) in a multivariate Cox analysis and were included in the construction of nomogram. In the training and testing sets, the C-index of the nomogram was 0.701 and 0.665, respectively, and the area under the ROC curve (AUROC) of the 1-, 3-, and 5-year overall survival rate was 0.749, 0.797, 0.833 and 0.730, 0.800, 0.832, respectively. The calibration curve shows that the nomogram is well-calibrated.ConclusionsThis is the first research to examine the prognosis of MMe patients based on the location. However, previous studies often focused on malignant pleural mesothelioma or malignant peritoneal mesothelioma with high incidence. Furthermore, a nomograph with good prediction efficiency was established according to the variables that influence patient survival outcomes, which provides us with a reference for clinical decision-making.

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

“…Extensive heterogeneity between patient is another major obstacle, requiring strati ed treatment, and interventions must carefully strike a balance between life expectancy and quality of life. Multiple prognostic factors of MPM have been described, including age [10,11], sex [10,11], chest pain [12], weight loss [12], performance status (PS) [13], histologic subtype [10,11,13,14], platelets (PLT) [13], hemoglobin (Hb) [15], serum albumin [15], the neutrophil-to-lymphocyte ratio (NLR) [14,16], the platelet-to-lymphocyte ratio (PLR) [17], the lymphocyteto-monocyte ratio (LMR)[18], C-reactive protein (CRP) [17], tumor volume (TV) [14], TNM stage [11], response to chemotherapy [10,11], type of surgery [11], etc. But validated prognostic indicators for MPM that can identify appropriate treatment and minimize patient discomfort during the nal stages of life are still lacking.…”