The Effect of Systemic Inflammation and Clinicopathologic Features on Survival in Malignant Pleural Mesothelioma: A Multicenter Analysis
<i>Background and Objectives:</i> Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy with a poor prognosis. Identifying reliable prognostic factors is crucial for risk stratification and optimizing treatment strategies. This study aimed to evaluate the impact of cli...
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2025-01-01
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| author | Nadiye Sever Sedat Yıldırım Ali Fuat Gurbuz Delyadil Karakaş Kılıç Esra Zeynelgil Yunus Emre Altintaş Berivan Deniz Çimik Yeşim Ağyol Ali Kaan Güren Pınar Erel Erkam Kocaaslan Burak Paçacı Mustafa Alperen Tunç Abdussamet Çelebi Nazım Can Demircan Selver Işık Rukiye Arıkan Murat Araz Serdar Karakaya Murat Sarı Osman Köstek İbrahim Vedat Bayoğlu |
| author_facet | Nadiye Sever Sedat Yıldırım Ali Fuat Gurbuz Delyadil Karakaş Kılıç Esra Zeynelgil Yunus Emre Altintaş Berivan Deniz Çimik Yeşim Ağyol Ali Kaan Güren Pınar Erel Erkam Kocaaslan Burak Paçacı Mustafa Alperen Tunç Abdussamet Çelebi Nazım Can Demircan Selver Işık Rukiye Arıkan Murat Araz Serdar Karakaya Murat Sarı Osman Köstek İbrahim Vedat Bayoğlu |
| author_sort | Nadiye Sever |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy with a poor prognosis. Identifying reliable prognostic factors is crucial for risk stratification and optimizing treatment strategies. This study aimed to evaluate the impact of clinicopathologic factors and systemic inflammatory markers on survival outcomes in patients with MPM. <i>Materials and Methods:</i> This retrospective, multicenter study included 217 patients diagnosed with MPM between January 2009 and March 2024. Data on age, gender, histology, disease stage, treatment modalities, and inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein/albumin ratio (CAR) were collected. Survival outcomes were analyzed using Kaplan–Meier methods, and prognostic factors were evaluated using Cox regression analysis. <i>Results:</i> CAR was identified as an independent prognostic factor for both overall survival (OS) and progression-free survival (PFS). Patients with CAR < 0.98 had significantly longer OS (87.0 months vs. 14.0 months, <i>p</i> < 0.001) and PFS (17.61 months vs. 8.96 months, <i>p</i> = 0.010). While NLR was significant in univariate analysis (OS: 25.0 months for NLR < 2.58 vs. 21.0 months for NLR ≥ 2.58, <i>p</i> = 0.040), it did not retain significance in the multivariate model (<i>p</i> = 0.180). Epithelioid histology and early-stage disease were strongly associated with improved survival outcomes (OS: 32.0 vs. 11.0 months for epithelioid vs. non-epithelioid histology, <i>p</i> < 0.001; 32.0 vs. 12.0 months for early-stage vs. metastatic disease, <i>p</i> < 0.001). <i>Conclusions:</i> CAR is a strong independent prognostic factor in MPM, reflecting systemic inflammation and nutritional status. Epithelioid histology and early-stage disease are associated with significantly longer survival, underscoring the critical role of early detection in improving patient outcomes. |
| format | Article |
| id | doaj-art-1a056459c7a94307b05de7e83f43fe73 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-1a056459c7a94307b05de7e83f43fe732025-01-24T13:40:50ZengMDPI AGMedicina1010-660X1648-91442025-01-0161114410.3390/medicina61010144The Effect of Systemic Inflammation and Clinicopathologic Features on Survival in Malignant Pleural Mesothelioma: A Multicenter AnalysisNadiye Sever0Sedat Yıldırım1Ali Fuat Gurbuz2Delyadil Karakaş Kılıç3Esra Zeynelgil4Yunus Emre Altintaş5Berivan Deniz Çimik6Yeşim Ağyol7Ali Kaan Güren8Pınar Erel9Erkam Kocaaslan10Burak Paçacı11Mustafa Alperen Tunç12Abdussamet Çelebi13Nazım Can Demircan14Selver Işık15Rukiye Arıkan16Murat Araz17Serdar Karakaya18Murat Sarı19Osman Köstek20İbrahim Vedat Bayoğlu21Medical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Kartal Training and Research Hospital, İstanbul 34865, TurkeyMedical Oncology, Department of Internal Medicine, Necmettin Erbakan University, Konya 42090, TurkeyMedical Oncology, Department of Internal Medicine, Dicle University Faculty of Medicine, Diyarbakır 21280, TurkeyMedical Oncology, Department of Internal Medicine, Ankara Ataturk Senatorium Training and Research Hospital, Ankara 06290, TurkeyMedical Oncology, Department of Internal Medicine, Kartal Training and Research Hospital, İstanbul 34865, TurkeyDepartment of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Başakşehir Çam and Sakura City Hospital, İstanbul 34480, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, TurkeyMedical Oncology, Department of Internal Medicine, Necmettin Erbakan University, Konya 42090, TurkeyMedical Oncology, Department of Internal Medicine, Ankara Ataturk Senatorium Training and Research Hospital, Ankara 06290, TurkeyMedical Oncology, Department of Internal Medicine, İstanbul Medipol University, İstanbul 34810, TurkeyMedical Oncology, Department of Internal Medicine, İstanbul Medipol University, İstanbul 34810, TurkeyMedical Oncology, Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul 34854, Turkey<i>Background and Objectives:</i> Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy with a poor prognosis. Identifying reliable prognostic factors is crucial for risk stratification and optimizing treatment strategies. This study aimed to evaluate the impact of clinicopathologic factors and systemic inflammatory markers on survival outcomes in patients with MPM. <i>Materials and Methods:</i> This retrospective, multicenter study included 217 patients diagnosed with MPM between January 2009 and March 2024. Data on age, gender, histology, disease stage, treatment modalities, and inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein/albumin ratio (CAR) were collected. Survival outcomes were analyzed using Kaplan–Meier methods, and prognostic factors were evaluated using Cox regression analysis. <i>Results:</i> CAR was identified as an independent prognostic factor for both overall survival (OS) and progression-free survival (PFS). Patients with CAR < 0.98 had significantly longer OS (87.0 months vs. 14.0 months, <i>p</i> < 0.001) and PFS (17.61 months vs. 8.96 months, <i>p</i> = 0.010). While NLR was significant in univariate analysis (OS: 25.0 months for NLR < 2.58 vs. 21.0 months for NLR ≥ 2.58, <i>p</i> = 0.040), it did not retain significance in the multivariate model (<i>p</i> = 0.180). Epithelioid histology and early-stage disease were strongly associated with improved survival outcomes (OS: 32.0 vs. 11.0 months for epithelioid vs. non-epithelioid histology, <i>p</i> < 0.001; 32.0 vs. 12.0 months for early-stage vs. metastatic disease, <i>p</i> < 0.001). <i>Conclusions:</i> CAR is a strong independent prognostic factor in MPM, reflecting systemic inflammation and nutritional status. Epithelioid histology and early-stage disease are associated with significantly longer survival, underscoring the critical role of early detection in improving patient outcomes.https://www.mdpi.com/1648-9144/61/1/144malignant pleural mesotheliomaC-reactive protein/albumin ratio (CAR)neutrophil/lymphocyte ratio (NLR)epithelioid histologysurvival |
| spellingShingle | Nadiye Sever Sedat Yıldırım Ali Fuat Gurbuz Delyadil Karakaş Kılıç Esra Zeynelgil Yunus Emre Altintaş Berivan Deniz Çimik Yeşim Ağyol Ali Kaan Güren Pınar Erel Erkam Kocaaslan Burak Paçacı Mustafa Alperen Tunç Abdussamet Çelebi Nazım Can Demircan Selver Işık Rukiye Arıkan Murat Araz Serdar Karakaya Murat Sarı Osman Köstek İbrahim Vedat Bayoğlu The Effect of Systemic Inflammation and Clinicopathologic Features on Survival in Malignant Pleural Mesothelioma: A Multicenter Analysis Medicina malignant pleural mesothelioma C-reactive protein/albumin ratio (CAR) neutrophil/lymphocyte ratio (NLR) epithelioid histology survival |
| title | The Effect of Systemic Inflammation and Clinicopathologic Features on Survival in Malignant Pleural Mesothelioma: A Multicenter Analysis |
| title_full | The Effect of Systemic Inflammation and Clinicopathologic Features on Survival in Malignant Pleural Mesothelioma: A Multicenter Analysis |
| title_fullStr | The Effect of Systemic Inflammation and Clinicopathologic Features on Survival in Malignant Pleural Mesothelioma: A Multicenter Analysis |
| title_full_unstemmed | The Effect of Systemic Inflammation and Clinicopathologic Features on Survival in Malignant Pleural Mesothelioma: A Multicenter Analysis |
| title_short | The Effect of Systemic Inflammation and Clinicopathologic Features on Survival in Malignant Pleural Mesothelioma: A Multicenter Analysis |
| title_sort | effect of systemic inflammation and clinicopathologic features on survival in malignant pleural mesothelioma a multicenter analysis |
| topic | malignant pleural mesothelioma C-reactive protein/albumin ratio (CAR) neutrophil/lymphocyte ratio (NLR) epithelioid histology survival |
| url | https://www.mdpi.com/1648-9144/61/1/144 |
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