Prognostic value of the lymphocyte-to-monocyte ratio and other inflammatory markers in malignant pleural mesothelioma. Issue 5 (September 2016) - Tanrikulu, Abdullah
Abstract Objectives Inflammation plays a role in malignant pleural mesothelioma (MPM) prognosis and symptoms. We investigated the roles of the new and old inflammatory indexes and markers in MPM prognosis. Methods Two hundred and ninety-two MPM patients (167 male and 125 female) were included in this retrospective study. Demographic parameters were collected from the patients' files. Kaplan–Meier curves and multivariate Cox regression analyses were used for the analysis of prognosis. Results The mean age of the patients was 58.4 years. The mean survival time was 14.6 ± 13.0 months. Twenty-four potential prognostic factors associated with a poor outcome were calculated in the univariate analysis, and 16 potential prognostic factors were associated with a poor prognosis. These 16 potential prognostic factors were also analyzed in multivariate analysis. Multivariate analysis showed that increased age, stage 3–4 disease, the non-epithelial type, a low Karnofsky performance score, a high white blood cell count, and a low lymphocyte-to-monocyte ratio (LMR) were associated with a poor prognosis. The results of the multivariate analysis showed that a decreased LMR was associated with poor survival. Patients with LMR ≤2.6 had poor survival compared with those with LMR >2.6 (mean 9.6 vs. 17.0 months, respectively;p = 0.004). Conclusions LMR is an independent marker of prognosis in patients with MPM and is superior to the other inflammation-based markers. The inexpensive nature and easy reproducibility of the hemogram should encourage the use of the LMR in clinical practice.