Page 48 - ECBIP 2021_Program

6th European Congress ECBIP 15 - 17
Book of Abstracts
for Bronchology and
Interventional Pulmonology ATHENS - GREECE 2021
OCTOBER
MODERATED e-POSTER SESSION 02:
Diseases of the pleura
PROGNOSTIC INDEX FOR CANCER OUTCOMES AS A PREDICTOR OF SURVIVAL IN MALIGNANT PLEURAL EFFUSIONS
Pedro Magalhães Ferreira1, Cláudia Freitas1,2, Mariana Serino1, Beatriz Martins1, David Coelho1,2, Rita Trovisco2, Natália Melo1, Adriana Magalhães1, Gabriela Fernandes1,2, Hélder Novais-Bastos1,2
1 Pulmonology Department, Centro Hospitalar Universitário De São João, Porto, Portugal 2 Faculty of Medicine, University of Porto, Porto, Portugal
PP13
Introduction: Development of a malignant pleural effusion (MPE) is often associated with rapid deterioration and poor prognosis. Despite having several prognostic scores validated for cancer patients, most are not specific for patients with MPE. We assessed the survival of these patients in our center using one of such scores, the Prognostic Index for Cancer Outcomes (PICO).
Methods: Retrospective study including patients with a confirmed diagnosis of MPE. PICO score was calculated using serum C-Reactive Protein (CRP: ≤10mg/L vs >10mg/L) and White Blood Cell (WBC: ≤11x109/L vs >11x109/L) count, with each patient being assigned a Good, Intermediate or Poor prognosis. We stratified their ECOG Performance Status classification into two categories: ECOG 0-1 and ECOG 2-4. Stratification according to cancer type was as follows: Group A (Mesothelioma), Group B (All other malignancies) and Group C (Lung cancer). Survival was determined by Kaplan- Meier curves and compared by log-rank test.A multivariate analysis was performed using Cox proportional hazard model.
Results: We analyzed 267 patients, of which 50.9% were male; mean age at MPE diagnosis was 66.9±12.9 years. Patients were divided according to PICO score in three groups: Good Prognosis (n=30), Intermediate Prognosis (n=150) and Poor Prognosis (n=87).One-third of the patients had an ECOG ≥2.At the time of diagnosis,56.6% of patients presented with large- volume pleural effusions through chest x-ray examination; pleural fluid cytology yielded a positive result for malignancy in 93.3% of cases. Lung was the main primary malignancy site (52.4%), followed by breast (11.6%) and hematological (5.6%) malignancies. Overall median survival was 92 (95%CI, 71.1-112.9) days. Median survival was significantly different between PICO score groups (p<0.001): 274 (95%CI, 60.6-487.4) days in the Good Prognosis group, 110 (95%CI, 86.7-133.3) days in the Intermediate Prognosis group, and 36 (95%CI, 18.2-53.8) days in the Poor Prognosis group. After adjusting for age at MPE diagnosis, sex, ECOG Performance Status and cancer type, the PICO score remained an independent predictor of survival among patients with MPE (Intermediate Prognosis vs Good Prognosis: HR 1.67 [95%CI, 1.09-2.54; p=0.018] and Poor Prognosis vs Good Prognosis: HR 2.79 [95%CI, 1.78-4.39; p<0.001]).
Conclusion: Despite its broader indication and the lack of pleural effusion-related parameters for the scoring system, we were able to demonstrate the PICO score as a possible predictor of survival in MPE patients. The accessibility and ease of application of this score enables the clinician to assess survival in this population without necessarily obtaining additional pleural fluid samples.
48 6th European Congress for Bronchology and Interventional Pulmonology