ArticleJournal of thoracic disease2026
Retrospective cohort study on prognostic factors of malignant pleural effusion secondary to pleural mesothelioma.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Malignant pleural effusion (MPE) frequently complicates pleural mesothelioma; however, prognostic determinants for this condition, particularly pleural fluid biomarkers, have yet to be comprehensively characterized. This study sought to assess the prognostic utility of clinical profiles and laboratory findings, with a specific focus on pleural fluid parameters, in patients with mesothelioma-associated MPE. Methods: This retrospective cohort study included patients diagnosed with MPE secondary to pleural mesothelioma at Tianjin Chest Hospital from January 2015 to May 2025. Inclusion criteria: age ≥18 years, confirmed diagnosis. Exclusion criteria: active infection, incomplete baseline clinical/laboratory data, or prior anti-tumor therapy. Follow-up was conducted via telephone at monthly intervals for 6 months then every 3 months. The primary outcome was overall survival (OS), defined as time from diagnosis to death or last follow-up. Univariable and multivariable Cox regression analyses were performed to identify independent prognostic factors. Results: Seventy‑one eligible patients were analyzed. Median OS was 30 months (range, 16-44 months). Four factors were independently associated with OS in multivariable analysis: pleural fluid lactate dehydrogenase (LDH) ≥361 U/L [hazard ratio (HR) 4.373, 95% confidence interval (CI): 1.903-10.049, P=0.001], fibrinogen (FIB) ≥3.82 g/L (HR 3.592, 95% CI: 1.683-7.666, P=0.001), mean platelet volume (MPV) ≥12.50 fL (HR 2.507, 95% CI: 1.125-5.586, P=0.03), and absolute lymphocyte count ≥1.48×10 Conclusions: These four routinely available baseline parameters-pleural fluid LDH, FIB, MPV, and absolute lymphocyte count-may serve as potential prognostic indicators in patients with MPE secondary to pleural mesothelioma. Prospective, multicenter studies with external validation are required to confirm these findings.
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