Journal of Clinical Oncology, Vol 16, 145-152, Copyright © 1998 by American Society of Clinical Oncology
Prognostic factors in patients with pleural mesothelioma: the European Organization for Research and Treatment of Cancer experience
D Curran, T Sahmoud, P Therasse, J van Meerbeeck, PE Postmus and G Giaccone
European Organization for Research and Treatment of Cancer Data Center, Brussels, Belgium.
PURPOSE: Identification of prognostic factors in patients with malignant
pleural mesothelioma based on prospectively collected international data.
PATIENTS AND METHODS: From October 1984 to October 1993, 204 eligible adult
patients with malignant pleural mesothelioma were entered into five
consecutive prospective European Organization for Research and Treatment of
Cancer (EORTC) phase II clinical trials designed to assess the efficacy of
various anticancer drugs (mitoxantrone, epidoxorubicin, etoposide, and
paclitaxel). The Cox model was used to assess 13 factors related to biology
and disease history with respect to survival. RESULTS: The median survival
duration was 12.6 months from diagnosis and 8.4 months from trial entry. In
the multivariate analysis, poor prognosis was associated with a poor
performance status, a high WBC count, a probable/possible histologic
diagnosis of mesothelioma, male gender, and having sarcomatous tissue as
the histologic subtype. Taking these five factors into consideration,
patients were classified into two groups: a good- prognosis group (1-year
survival rate, 40%; 95% confidence interval [CI], 30% to 50%) and a
poor-prognosis group (1-year survival, 12%; 95% CI, 4% to 20%). CONCLUSION:
These results may help to design new clinical trials in pleural
mesothelioma by selecting more homogenous groups of patients.
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