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Staging model for mesothelioma validated: Study supports continued use of model
A model developed by the International Association for the Study of Lung Cancer in 2009 to help better stage mesothelioma cases performed well, according to an independent analysis presented at The International Association for the Study of Lung Cancer (IASLC) 2023 Conference in Singapore.
Pleural mesothelioma is a rare but aggressive cancer primarily caused by asbestos exposure and presents complex challenges for effective staging and prognostication.
The IASLC took a significant step in 2009 by establishing an international pleural mesothelioma database aimed at enhancing staging accuracy. Subsequently, in 2014, an analysis of data from 1995 to 2009 led to the identification of supplemental prognostic factors. The current study sought to validate and enhance these models using fresh clinical data.
The research, presented by Andrea Wolf, M.D., from The Icahn School of Medicine at Mount Sinai, in New York City, evaluated data from patients entered into the database between 2009 and 2019, constituting a validation cohort of 1,733 individuals.
The study introduced additional variables for analysis, with model comparison based on Harrell's C-index. Two distinct models were evaluated: one incorporating clinicopathological features and treatment (pathologic staging model), and the other encompassing parameters available at patient presentation (basic presentation model).
The training dataset, comprising 3,101 patients, revealed a significant optimal cut-point for mesothelin at 6.7 nmol/L using the running log-rank method. Univariate analysis highlighted anemia and elevated mesothelin levels as predictors of poorer survival.
"Our study highlights the significant strides made in pleural mesothelioma staging. By refining and validating prognostic models, we are advancing our ability to tailor treatment strategies and improve patient outcomes," said Dr. Wolf. "Continued efforts to gather and analyze data will improve prognostication and individualized patient care."
