Prognostic value of SUVpeak and prognostic nutritional index in patients with pleural mesothelioma treated with platinum-based chemotherapy
Low prognostic nutritional index (PNI) (≤ 45) was an independent prognostic factor for worse overall survival (OS) (hazard ratio: 2.04, P = 0.04) in patients with pleural mesothelioma (PM) treated with platinum‑pemetrexed chemotherapy.
We investigated the prognostic value of the Glasgow prognostic score, prognostic nutritional index (PNI), neutrophil‑to‑lymphocyte ratio, body mass index, and baseline FDG‑PET parameters in 79 patients with pleural mesothelioma treated with first‑line platinum‑pemetrexed chemotherapy. In 51 patients who received the combination therapy, the median age was 69 years (range 42–81), 78 % were male, and 67 % had epithelioid histology. The objective response rate was 27.5 % and the disease control rate was 72.5 %. Median progression‑free survival was 5.8 months and median overall survival was 21.8 months. Low PNI (≤ 45) was significantly associated with shorter overall survival than high PNI (> 45) (18.8 vs. 28.5 months; P = 0.04) and remained an independent prognostic factor in multivariable analysis (P = 0.04). High peak standardized uptake value (SUV_peak > 7.73) on baseline ^18F‑FDG‑PET was also significantly associated with worse overall survival (9.1 vs. 33.6 months; P < 0.001) and remained an independent predictor in multivariable analysis (P < 0.001). Other biomarkers such as GPS, NLR, and BMI did not predict survival in univariate analysis. None of the biomarkers predicted progression‑free survival. Low PNI and high SUV_peak therefore provide independent prognostic information for patients with pleural mesothelioma receiving platinum‑pemetrexed chemotherapy.
Low PNI and high SUV_peak significantly predicted poor OS in patients with pleural mesothelioma treated with platinum‑based chemotherapy. These factors may serve as practical prognostic indicators in this population.
Bizonyítékszint: Klinikai vizsgálat. Formális klinikai vizsgálati eredmény.
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