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タイトル: | A new prognostic index for overall survival in malignant pleural mesothelioma: the rPHS (regimen, PS, histology or stage) index. |
著者: | Kataoka, Yuki Yamamoto, Yosuke https://orcid.org/0000-0003-1104-2612 (unconfirmed) Otsuki, Taiichiro Shinomiya, Mariko Terada, Takayuki Fukuma, Shingo https://orcid.org/0000-0002-8379-8761 (unconfirmed) Yamazaki, Shin Hirabayashi, Masataka Nakano, Takashi Fukuhara, Shunichi |
著者名の別形: | 福原, 俊一 |
キーワード: | malignant pleural mesothelioma pemetrexed best supportive care prognostic index palliative care |
発行日: | Jun-2015 |
出版者: | Oxford University Press |
誌名: | Japanese journal of clinical oncology |
巻: | 45 |
号: | 6 |
開始ページ: | 562 |
終了ページ: | 568 |
抄録: | [Objective] Existing prognostic indices for malignant pleural mesothelioma do not incorporate the recent advances in oncology care. The purpose of this study was to provide a prognostic index for overall survival in malignant pleural mesothelioma patients treated with chemotherapy with pemetrexed or best supportive care in the recent clinical setting. [Methods] A retrospective cohort study was performed in two hospitals in Japan (2007–13). The primary outcome was overall survival. The Cox proportional hazards model was used for multivariable analyses to identify prognostic factors. A final model was chosen based on both clinical and statistical significance. [Results] A total of 283 patients (chemotherapy: n = 228, best supportive care: n = 55) were enrolled in the study. On multivariate analysis, regimen including platinum plus pemetrexed, a performance status >0, non-epithelial histological type and Stage IV disease predicted poor overall survival in chemotherapy patients. As hazard ratios of individual risk factors were approximately similar, a prognostic index for overall survival was constructed by counting the risk factors. Median overall survival in chemotherapy patients decreased by each one-point increase in this count: 1030 days for zero; 658 days for one; 373 days for two; 327 days for three; 125 days for four. Internal validation using the bootstrapping technique showed robustness of the model (c-index, 0.677; 95% confidence interval, 0.624–0.729). Further, the discrimination was consistent in best supportive care patients (c-index, 0.799; 95% confidence interval, 0.725–0.874). [Conclusions] This novel index can provide clinicians and malignant pleural mesothelioma patients with a better framework for discussing prognosis at the time of diagnosis. |
記述: | First published online: April 2, 2015 |
著作権等: | This is a pre-copyedited, author-produced PDF of an article accepted for publication in 'Japanese journal of clinical oncology' following peer review. The version of record [Yuki Kataoka, Yosuke Yamamoto, Taiichiro Otsuki, Mariko Shinomiya, Takayuki Terada, Shingo Fukuma, Shin Yamazaki, Masataka Hirabayashi, Takashi Nakano, Shunichi Fukuhara. A new prognostic index for overall survival in malignant pleural mesothelioma: the rPHS (regimen, PS, histology or stage) index. Japanese Journal of Clinical Oncology (2015) 45 (6): 562-568. doi: 10.1093/jjco/hyv039] is available online at: http://jjco.oxfordjournals.org/content/45/6/562. This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。 |
URI: | http://hdl.handle.net/2433/202002 |
DOI(出版社版): | 10.1093/jjco/hyv039 |
PubMed ID: | 25838292 |
出現コレクション: | 学術雑誌掲載論文等 |
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