Although numerous prognostic biomarkers were described in malignant pleural mesothelioma (MPM), the role of hyperglycemia has not been studied. We examined reported prognostic variables and glycemia as predictors of overall survival (OS) in a cohort of MPM patients.
This retrospective study included 148 consecutive patients diagnosed with MPM in two hospitals from Catalonia between 2007 and 2016. Clinicopathological characteristics and baseline analytical results were recorded. OS was calculated using Kaplan-Meier method and multivariate Cox model was adjusted by clinical variables that were statistically significant in the univariate Cox regression.
Most patients were male (73%) and 56% were ≥ 70 years. The most frequent histological subtype was epithelioid (59.5%), followed by sarcomatoid (18%), biphasic (13.5%) and not specified (10%). Disease stages at diagnosis were: stage I, 11.5%; stage II, 16%; stage III, 33%; stage IV, 34%; not specified, 1.5%. Most patients had good ECOG performance status (PS 0-1, 63%) and 63% of patients received chemotherapy. Median baseline glycemia was 5.8 mmol/l (3.9-15.9) and patients 34 (23%) had hyperglycemia (≥7 mmol/l) and 26 (18%) previous diagnosis of diabetes. The median overall survival (OS) was 10.5 months (95% CI 7.6 – 13.4). In the univariate analysis for OS, histological subtype, stage, PS, chemotherapy treatment, hyperglycemia (≥7 mmol/l), high neutrophil and platelets count, low lymphocytes and and high neutrophil to lymphocyte ratio (NLR) were significantly associated with survival outcome. In the multivariate Cox model adjusted by histological subtype, stage and PS, baseline glycemia (HR 1.80, 95% CI 1.08-2.98, p = 0.023, Table) and neutrophil count (HR 1.42, 95% CI 1.01-1.98, p = 0.042) remained as independent prognostic factors for shorter OS.Table:
1621P Multivariate Cox Regression Analysis of Overall Survival
|HR (95% CI)||p-value|
|Histology (non-epithelioid vs. epithelioid)||2.16 (1.42 - 3.26)|
Baseline hyperglycemia was independently associated with shorter survival in this cohort of patients with MPM. Confirmation of its prognostic role in larger cohorts is warranted.
Clinical trial identification
Legal entity responsible for the study
Catalan Institute of Oncology
Instituto de Salud Carlos III (PI14-01109)
All authors have declared no conflicts of interest.