Author of

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  P3.06 - Poster Session 3 - Prognostic and Predictive Biomarkers (ID 178)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Biology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12482

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    P3.06-042 - Pleural fluid ADA is associated with survival of patients with malignant pleural effusion (ID 2797)

    09:30 - 09:30  |  Author(s): L. Antonangelo
    • Abstract

    Background
    Estimating survival is desirable to determine the best palliative approach for patients with malignant pleural effusion (MPE). Previous studies have shown that some pleural fluid biochemical parameters as glucose or pH are predictors of survival in such a population. Inflammatory infiltrate profile was already determined as a relevant predictor in solid tumors. However, inflammatory cells profile and lymphocyte activity was not systematically assessed as a survival predictor in MPE patients. Therefore, our objective was to evaluate whether cytology profile and Adenosine Deaminase (ADA) levels are relevant predictors of overall survival in patients with MPE who undergo pleurodesis.

    Methods
    Retrospective cohort study carried out in a tertiary university-based hospital. We included all patients who underwent pleurodesis for MPE treatment in our institution during the period: Jan/08 to Jun/11. We excluded patients that had no pleural fluid analysis registered in our database. The following data regarding pleural fluid analysis were retrieved from our database: glucose, LDH, total proteins and ADA, total cell count, leukocytes, macrophages, neutrophils, lymphocytes and oncotic cytology. All patients were followed up in our outpatient clinic until death, those who were lost to follow-up were contacted by telephone. Cox regression models were built to identify predictors of overall survival

    Results
    156 patients were included in this study (44 men, 112 women, mean age 58.9+-12 years). Primary neoplasms were: breast (83), lung (39), lymphoma (10), other (24). Median survival was 9 months. The final regression model was built using forward stepwise selection and the overall survival predictors identified that levels of ADA below 15 IU/L (HR:2.3, p=0.0008) or above > 40 IU/L. (HR 2.3, p=0.01) are associated with a shorter survival. An association with shorter survival was also found for patients with primary neoplasms different from breast, lung or lymphoma. (HR: 2,1, p= 0.007). No other predictor analyzed was associated with worse prognosis. Exploratory analysis showed that patients with ADA < 15 IU/L had low pleural fluid lymphocytes count and low protein concentration; paradoxically, those with ADA > 40 IU/L also had low lymphocytes count while other parameters were normal.

    Conclusion
    We concluded that ADA is a relevant predictor of survival in patients with MPE who undergo pleurodesis.