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Y. Ichinose
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P2.09 - Mesothelioma (ID 710)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Mesothelioma
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.09-005 - The C-reactive Protein/Albumin Ratio is a Novel Significant Prognostic Factor in Patients with Malignant Pleural Mesothelioma (ID 7375)
09:30 - 09:30 | Author(s): Y. Ichinose
- Abstract
Background:
Malignant pleural mesothelioma (MPM) is a devastating neoplasm. However, some patients show a good response to chemotherapy or multidisciplinary therapy. It is therefore important to investigate the factors that can be used to select patients who will benefit from such treatment. The C-reactive protein/albumin ratio (CAR) has been used to predict the prognosis in other diseases. The aim of this study was to elucidate the prognostic utility of the CAR in MPM patients.
Method:
The data of 83 patients, who were treated with surgery, chemotherapy, or multidisciplinary therapy at National Kyushu Cancer Center between 1995 and 2015, were analyzed in the present study. The CAR was calculated as C-reactive protein value divided by albumin value using the results of blood examination just prior to starting the treatments. A cut-off value of CAR was set to 0.58 according to the receiver operating characteristics (ROC) curve for 1-year-survival.
Result:
Thirty of the 83 (36.1%) patients were classified into the high CAR group. Twenty-seven (32.5%) and 56 (67.5%) patients underwent surgery and only chemotherapy, respectively. The ROC curve showed that the CAR had good diagnostic ability with 78.9% sensitivity and 68.0% specificity (AUC=0.761). A high CAR group was significantly correlated with advanced clinical stage (III/IV) (p=0.002) and chemotherapy alone (p=0.005). The high CAR group had significantly poorer overall survival (OS) (p<0.001) and disease or progression free survival (DFS/PFS) (p<0.001). The clinical stage and the CAR were independent predictive factors for the OS (I/II and III/IV, p=0.008; ≤0.58 and >0.58, p=0.034, respectively). The clinical stage and the CAR were also independent predictive factors for the DFS/PFS (I/II and III/IV, p=0.031; ≤0.58 and >0.58, p=0.019, respectively). In the subgroup analysis of the patients who underwent only chemotherapy, the high CAR group showed significantly poorer OS and DFS/PFS compared with the low CAR group (p=0.002 and p<0.001, respectively). However, the difference in OS and DFS/PFS of the patients who underwent surgery was not apparent between the high and low CAR groups (p=0.061 and p=0.187, respectively).
Conclusion:
The CAR was an independent predictor of a poor prognosis in the MPM patients. The high CAR group showed a significantly poorer prognosis in patients with MPM treated by only chemotherapy. This score provides useful information for selecting patients who will benefit from treatment, especially chemotherapy. These findings should be validated in further prospective studies.
