1533P - Expression of Wilm’s acute tumour gene (WT1) is associated with survival in malignant pleural mesothelioma: retrospective analysis in a single cen...

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Mesothelioma
Translational Research
Presenter Susana Cedres
Authors S. Cedres1, D. Torrejon Castro2, N. Stjepanovic2, P. Martinez2, A. Martinez2, M. Salcedo2, M.A. Montero2, E. Felip2
  • 1Medical Oncology, Vall d`Hebron University Hospital Institut d'Oncologia, 08035 - Barcelona/ES
  • 2Medical Oncology, Vall d´Hebron University Hospital, Barcelona/ES

Abstract

Background

Calretinin and Wilmstumour gene (WT1) are mesothelial markers used to confirm the diagnosis of malignant pleural mesothelioma (MPM). Recently, calretinin score assessed by immunohistochemistry (IHC) was implicated with poor prognosis in MPM. We investigated the prognostic value of calretinin and WT1 expression in predicting survival in a series of patients (p) diagnosed of MPM in our institution

Methods

Fifty two patients diagnosed of MPM in Vall d´Hebron University Hospital were retrospectively reviewed. Potential prognostic factors analyzed were age, performance status (PS), neutrophil to lymphocyte ratio (NLR), clinical stage, histology, calretinin and WT1 expression. Survival data were calculated by Kaplan-Meier.

Results

Patient's characteristics: median age 68 years (31-88 years), males 75.5%, PS 1: 67.3%, asbestos exposure 53.1%, clinical stage III: 55.1%, epithelial subtype 71.4% and NLR > 5 in 44.9% of all patients. Calretinin and WT1 IHC expression were available in 47 p and 32 p, and were positive in 41 p (83.7%) and 25 p (78.1%) respectively. All patients were considered initially unresectable and 71.4% received CT. We found a significant association of calretinin and WT1 expression with epithelial histology (p= 0.030 and p = 0.010). The median survival (OS) was 15.2 months. We found a significant increase in OS in patients with epithelial subtype (23.4 vs 5.0 months in epithelial vs no-epithelial, p < 0.001), PS1 (14.7 vs 2.2 m in PS 1 vs PS 2, p = 0.036) and NLR ≤5 (26.5 vs 13.4 m, p = 0.025). In the IHC markers analysis we found a significant increase in OS for p with WT1 positive expression (16.4 vs 2.3 m, p= 0.013), but not differences for calretinin expression (16.6 m vs 5.0 months, p = 0.37). In the multivariate analysis epithelial histology and WT1remained as significant prognostic factors for survival (HR 22.8; 95%CI,2.7-190, p = 0.004 and HR 9.5; 95%CI 1.7-52.3, p = 0.010 respectively).

Conclusion

In our series of 52 MPM patients, epithelial histology, PS, NLR and WT1 expression are significant prognostic factors for survival. The prognostic role of WT1 is worth of prospective validation in future studies on MPM.

Disclosure

All authors have declared no conflicts of interest.