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Title: A new prognostic index for overall survival in malignant pleural mesothelioma: the rPHS (regimen, PS, histology or stage) index.
Authors: Kataoka, Yuki
Yamamoto, Yosuke  kyouindb  KAKEN_id  orcid (unconfirmed)
Otsuki, Taiichiro
Shinomiya, Mariko
Terada, Takayuki
Fukuma, Shingo  kyouindb  KAKEN_id  orcid (unconfirmed)
Yamazaki, Shin
Hirabayashi, Masataka
Nakano, Takashi
Fukuhara, Shunichi  kyouindb  KAKEN_id
Author's alias: 福原, 俊一
Keywords: malignant pleural mesothelioma
best supportive care
prognostic index
palliative care
Issue Date: Jun-2015
Publisher: Oxford University Press
Journal title: Japanese journal of clinical oncology
Volume: 45
Issue: 6
Start page: 562
End page: 568
Abstract: [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.
Description: First published online: April 2, 2015
Rights: 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:
This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1093/jjco/hyv039
PubMed ID: 25838292
Appears in Collections:Journal Articles

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