TY - JOUR
T1 - The International Association for the Study of Lung Cancer Pleural Mesothelioma Staging Project
T2 - Updated Modeling of Prognostic Factors in Pleural Mesothelioma
AU - International Association for the Study of Lung Cancer (IASLC) Staging and Prognostic Factors Committee
AU - Wolf, Andrea S.
AU - Rosenthal, Adam
AU - Giroux, Dorothy J.
AU - Nowak, Anna K.
AU - Bille, Andrea
AU - de Perrot, Marc
AU - Kindler, Hedy L.
AU - Rice, David
AU - Opitz, Isabelle
AU - Rusch, Valerie W.
AU - Pass, Harvey I.
N1 - Funding Information:
Disclosure: Dr. Rusch receives institutional clinical trial funding from Genentech; funds for meeting preparation and travel reimbursement from the National Institutes of Health/National Cancer Institute (NIH/NCI) Thoracic Malignancy Steering Committee; and is an unpaid member of the Data Safety Monitoring Committee, Mesothelioma and Radical Surgery 2 trial (Cancer Research United Kingdom). Dr. Opitz reports receiving an institutional grant and participates in the speakers bureau for Roche; participates in the advisory board and speakers bureau for AstraZeneca; participates in an advisory board for Merck Sharp & Dohme and Bristol-Myers Squibb; receives institutional grant from Medtronic; and conducts proctorship for Intuitive. The remaining authors declare no conflict of interest.
Publisher Copyright:
© 2023 International Association for the Study of Lung Cancer
PY - 2023/12
Y1 - 2023/12
N2 - Introduction: The International Association for the Study of Lung Cancer developed an international pleural mesothelioma database to improve staging. Data entered from 1995 to 2009 (training data set) were analyzed previously to evaluate supplemental prognostic factors. We evaluated these factors with new clinical data to determine whether the previous models could be improved. Methods: Patients entered into the database from 2009 to 2019 (validation cohort) were assessed for the association between previous prognosticators and overall survival using Cox proportional hazards regression with bidirectional stepwise selection. Additional variables were analyzed and models were compared using Harrell's C-index. Results: The training data set included 3101 patients and the validation cohort, 1733 patients. For the multivariable pathologic staging model applied to the training cohort, C-index was 0.68 (95% confidence interval [CI]: 0.656–0.705). For the validation data set (n = 497), C-index was 0.650 (95% CI: 0.614–0.685), and pathologic stage, histologic diagnosis, sex, adjuvant therapy, and platelet count were independently associated with survival. Adding anemia to the model increased the C-index to 0.652 (95% CI: 0.618–0.686). A basic presentation model including all parameters before staging yielded a C-index of 0.668 (95% CI: 0.641–0.695). In comparison, the European Organization for Research and Treatment of Cancer model yielded C-indices of 0.550 (95% CI: 0.511–0.589) and 0.577 (95% CI: 0.550–0.604) for pathologic staging and presentation models, respectively. Conclusions: Although significant predictors differed slightly, the International Association for the Study of Lung Cancer training model performed well in the validation set and better than the model of the European Organization for Research and Treatment of Cancer. International collaboration is critical to improve outcomes in this rare disease.
AB - Introduction: The International Association for the Study of Lung Cancer developed an international pleural mesothelioma database to improve staging. Data entered from 1995 to 2009 (training data set) were analyzed previously to evaluate supplemental prognostic factors. We evaluated these factors with new clinical data to determine whether the previous models could be improved. Methods: Patients entered into the database from 2009 to 2019 (validation cohort) were assessed for the association between previous prognosticators and overall survival using Cox proportional hazards regression with bidirectional stepwise selection. Additional variables were analyzed and models were compared using Harrell's C-index. Results: The training data set included 3101 patients and the validation cohort, 1733 patients. For the multivariable pathologic staging model applied to the training cohort, C-index was 0.68 (95% confidence interval [CI]: 0.656–0.705). For the validation data set (n = 497), C-index was 0.650 (95% CI: 0.614–0.685), and pathologic stage, histologic diagnosis, sex, adjuvant therapy, and platelet count were independently associated with survival. Adding anemia to the model increased the C-index to 0.652 (95% CI: 0.618–0.686). A basic presentation model including all parameters before staging yielded a C-index of 0.668 (95% CI: 0.641–0.695). In comparison, the European Organization for Research and Treatment of Cancer model yielded C-indices of 0.550 (95% CI: 0.511–0.589) and 0.577 (95% CI: 0.550–0.604) for pathologic staging and presentation models, respectively. Conclusions: Although significant predictors differed slightly, the International Association for the Study of Lung Cancer training model performed well in the validation set and better than the model of the European Organization for Research and Treatment of Cancer. International collaboration is critical to improve outcomes in this rare disease.
KW - Extrapleural pneumonectomy
KW - Mesothelioma
KW - Pleurectomy/decortication
KW - Prognostic factors
KW - Staging
UR - http://www.scopus.com/inward/record.url?scp=85178206603&partnerID=8YFLogxK
U2 - 10.1016/j.jtho.2023.08.005
DO - 10.1016/j.jtho.2023.08.005
M3 - Article
C2 - 37567386
AN - SCOPUS:85178206603
SN - 1556-0864
VL - 18
SP - 1689
EP - 1702
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 12
ER -