Pleural Fluid Analysis in Malignant Mesothelioma

Gottehrer, Andrew; Taryle, David A.; Reed, Carolyn E.; Sahn, Steven A.

doi:10.1378/chest.100.4.1003

Cited by 38 publications

(22 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In another study, performed on 26 patients, to evaluate pleural fluid parameters, it was reported that the pleural fluid glucose level and pleural fluid pH were associated with MPM prognosis [33]. In our study, we found that a lower pleural fluid glucose level was also associated with a poor prognosis of MPM.…”

Section: Discussionsupporting

confidence: 71%

A Clinical, Radiographic and Laboratory Evaluation of Prognostic Factors in 363 Patients with Malignant Pleural Mesothelioma

Tanrıkulu

Abakay

Kaplan³

et al. 2010

Respiration

View full text Add to dashboard Cite

Background: Malignant pleural mesothelioma (MPM) has a poor prognosis. Objectives: Only few studies in literature investigated the presence of pleural fluid and radiographic findings for the prognosis of MPM. Methods: We retrospectively investigated the hospital charts of 363 MPM patients who were diagnosed from January 1989 to March 2010. Survival time was calculated by the Kaplan-Meier method. Pretreatment clinical, laboratory and radiographic features of each patient at the time of diagnosis were obtained from patients’ charts. Results: The mean age of 363 patients (217 men, 146 women) was 50.6 ± 11.2 years (range 19–85) and the mean survival time was 11.7 ± 8.6 months (range 1–53). Histological types of MPM were epithelial (71.2%), mixed (15.9%) and sarcomatous type (4.9%). The frequency of disease stages were 31.4% for stage 1, 24.2% for stage 2, 28.6% for stage 3 and 15.8% for stage 4. The most frequent symptoms were dyspnea (82.1%), chest pain (68.3%) and weight loss (58.9%). Results of univariate and multivariate analyses revealed that a Karnofsky performance score ≤60, a pleural fluid glucose level ≤40 mg/dl, a C-reactive protein level >50 mg/l, a serum lactate dehydrogenase level >500 U/l, the presence of pleural fluid, pleural thickening >1 cm and a platelet count of >420 × 10³/µl were found to be associated with poor prognosis in MPM. Conclusions: Our data suggest that low pleural fluid glucose and high C-reactive protein, the presence of pleural fluid and pleural thickening were associated with poor MPM prognosis. Further prospective studies are needed to highlight prognostic factors more clearly.

show abstract

Section: Discussionsupporting

confidence: 71%

A Clinical, Radiographic and Laboratory Evaluation of Prognostic Factors in 363 Patients with Malignant Pleural Mesothelioma

Tanrıkulu

Abakay

Kaplan³

et al. 2010

Respiration

View full text Add to dashboard Cite

show abstract

“…Moreover, survival among these 3 treated patients averaged 10.5 ± 3.10 months, a result not different from the mean survival (13.74 ± 3.36 months) for the group with ppH ≤7.32, excluding the 3 patients (p = 0.43). Thus, in our study, management was essentially similar for all patients, in contrast to the study by Gottehrer et al [4], in which treatment was not described in detail and was presumably not uniform.…”

Section: Discussioncontrasting

confidence: 56%

“…Because all our patients were treated similarly, the hypothesis of Gottehrer et al [4] – that ppH is a clinically significant univariate prognostic factor in this disease – is strengthened. Although 3 of our patients in the group with ppH ≤7.32 had other therapy, this level of doxorubicin and radiation therapy did not affect survival [10].…”

Section: Discussionmentioning

confidence: 87%

“…Gottehrer et al [4] retrospectively reviewed ppH in 17 mesothelioma patients and reported that survival was significantly shorter among patients with ppH <7.30: patients with ppH <7.30 survived a mean 4.7 ± 1.0 months versus patients with ppH ≥7.30 who survived a mean 10.9 ± 1.8 months. Most of these patients were diagnosed by closed needle biopsy.…”

Section: Introductionmentioning

confidence: 99%

“…Pathologists often consider the small specimens obtained by this technique inadequate for reaching a definitive diagnosis of mesothelioma. Of the 17 patients in the study of Gottehrer et al [4], 2 (only 15%) had diagnoses confirmed by autopsy. The tissue type of mesothelioma was not described.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic Value of Pleural Fluid pH in Malignant Epithelial Mesothelioma after Talc Poudrage

Aelony

Yao²,

King³

2006

Respiration

View full text Add to dashboard Cite

Background: Current staging schemes for malignant mesothelioma are inadequate. The most accurate staging may require pneumonectomy – a procedure associated with many complications. The pH of pleural fluid (ppH) predicts survival in nonmesotheliomatous malignant pleural effusions, suggesting that this noninvasive test might be useful for prognostication in malignant mesothelioma. Objective: It was the aim of this study to determine whether baseline ppH correlates with survival in malignant epithelial pleural mesothelioma. Methods: We reviewed survival data in patients treated with thoracoscopic talc pleurodesis whose final diagnosis was epithelial malignant pleural mesothelioma and whose chart recorded a ppH determination performed just before thoracoscopy. We monitored 26 patients until April 2002 (25 of these patients died), identifying cutoff ppH values that discriminate best for survival; Cox proportional hazards models were recursively run by increasing the ppH cutoff value by 0.02 each time. Results: The mean follow-up time was 19 ± 14 months. Mean ppH was 7.30 ± 0.09, and median ppH was 7.32. Several cutoff points correlated with a statistically significant difference in survival, but ppH 7.32 was associated with the greatest value for the area under the curve. Patients with ppH >7.32 lived a median of 21.2 months (95% confidence interval 16.5–30.0 months) after diagnosis compared with patients who had ppH ≤7.32 and lived a median of 13.4 months (95% confidence interval 4.5–16.2 months; p = 0.0194). Conclusions: Baseline ppH correlates with survival in epithelial mesothelioma patients treated palliatively with pleurodesis by thoracoscopic talc poudrage. This noninvasive test – ppH – should be included when staging patients with malignant mesothelioma.

show abstract

Prognostic factors of malignant mesothelioma of the pleura

Anand

1994

Cancer

View full text Add to dashboard Cite

Pleural Fluid Analysis in Malignant Mesothelioma

Cited by 38 publications

References 16 publications

A Clinical, Radiographic and Laboratory Evaluation of Prognostic Factors in 363 Patients with Malignant Pleural Mesothelioma

A Clinical, Radiographic and Laboratory Evaluation of Prognostic Factors in 363 Patients with Malignant Pleural Mesothelioma

Prognostic Value of Pleural Fluid pH in Malignant Epithelial Mesothelioma after Talc Poudrage

Prognostic factors of malignant mesothelioma of the pleura

Contact Info

Product

Resources

About