Metintas et al identified a number of risk factors for poor prognosis in a patient with a diffuse malignant pleural mesothelioma. These can help identify a patient who may benefit from more aggressive management. The authors are from Osmangazi University in Eskisehir, Turkey, and Llandough Hospital in Cardiff, UK.
Parameters identified on multivariate analysis:
(1) age
(2) clinical tumor stage
(3) Karnofsky performance scale
(4) serum LDH
Parameter |
Finding |
Points |
age of the patient |
< 75 years |
0 |
|
>= 75 years of age |
1 |
clinical tumor stage |
I |
0 |
|
II, III, or IV |
1 |
Karnofsky performance scale |
>= 70 |
0 |
|
< 70 |
1 |
serum LDH |
< 500 IU/L |
0 |
|
>= 500 IU/L |
1 |
where:
• The risk ratios ranged from 1.7 to 2.6.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the greater the risk of a poor outcome.
Limitations:
• The authors did not specify the method, instrument or normal reference range for the serum LDH.
Specialty: Hematology Oncology, Surgery, general, Pulmonology