Hyaluronan content in pleural fluid as a prognostic factor in patients with malignant pleural mesothelioma

BACKGROUND. Regardless of the modality of therapy used, malignant pleural m esothelioma is a highly treatment-resistant and invariably fatal disease. I dentification of prognostic variables are important for future investigatio nal therapeutic studies. METHODS. The prognostic significance of various clinical variables, includi ng hyaluronan levels in pleural fluid, was evaluated in a retrospective ana lysis in 100 patients with histologically confirmed malignant pleural mesot helioma. RESULTS. The overall median survival was 11.5 months. Univariate analyses i dentified histologic subtype, i.e., epithelial or mixed, and elevated conte nt of hyaluronan in the pleural effusion as significant prognostic variable s. A multivariate analysis confirmed the independent predictive power of hi stologic subtype, and an elevated concentration of hyaluronan in the pleura l fluid also indicated longer survival in older patients and in patients re ceiving therapy other than supportive. CONCLUSIONS. The prognostic value of histologic subtype and the concentrati on of hyaluronan in pleural effusions should be considered when designing a nd evaluating treatment trials for patients with malignant pleural mesothel ioma. (C) 2001 American Cancer Society.