Ki67 Tumor Expression Predicts Treatment Benefit Achieved by Macroscopic Radical Lung-Preserving Surgery in Pleural Mesothelioma-A Retrospective Multicenter Analysis.

Pleural mesothelioma (PM), linked to asbestos-induced inflammation, carries a poor prognosis. Therapy ranges from therapy limitation to aggressive multimodality treatment. Given the uncertainty about treatment benefits for patients, this study aimed to assess the role of Ki67 as a prognostic and predictive parameter in PM. Ki67 was measured in the specimens of 70 PM patients (17 female, 53 male) from two centers and correlated to overall survival (OS) and therapy outcome. The median OS was 16.1 months. The level of Ki67 expression was divided into low (≤15%) and high (>15%). A low value of Ki67 expression was associated with a longer OS (Ki67 ≤ 15%: 31.2 (95% CI 6.5-55.8) months vs. Ki67 > 15%: 11.1 (95% CI 7.7-14.6) months, p = 0.012). The 5-year survival represents 22% in the low Ki67 expression group, in contrast to 5% in the high Ki67 expression group. We found a significant interaction term of Ki67 with multimodality treatment (p = 0.031) translating to an OS of 48.1 months in the low expression Ki67 group compared to 24.3 months in the high Ki67 expression group when receiving surgery within multimodality therapy. Therefore, Ki67 stands out as a validated prognostic and, most importantly, novel predictive biomarker for treatment benefits, particularly regarding surgery within multimodality therapy.

Videothoracoscopic surgery in children.

Video-assisted thoracic surgery (VATS) is now being used with increasing frequency for a wide variety of indications in pediatric patients. Although there is no high level of evidence for the advantages of VATS in the pediatric patient group, the proven benefits of this method in the adult patient group have encouraged thoracic surgeons to perform VATS in this patient population. In this study, the procedures performed in pediatric patients under 18 years of age and their results were reviewed with the help of articles obtained as a result of searches using relevant keywords in the English literature (PubMed, Web of Science, EMBASE, and Cochrane). The frequency, indications, and results of the procedures performed differed according to age groups.

The Diagnostic Accuracy of the Hounsfield Unit Value in Pulmonary Embolism.

Objective: Pulmonary embolism (PE) a vascular disease. Computed tomography pulmonary angiography (CTPA) is the radiological imaging technique used to diagnose PE. In this study, we aimed to demonstrate the diagnostic accuracy of Hounsfield Unit (HU) value for PE based on the hypothesis that acute thrombosis causes an increase in HU value on computed tomography (CT). Methods: This research was as a single-center, retrospective study. Patients presenting to the emergency department (ED) diagnosed with PE on CTPA were enrolled as the study group. In addition, patients admitted to the same emergency department who were not diagnosed with PE and had non-contrast CT scans were included as the control group. A receiver operating curve (ROC) was produced to the diagnostic accuracy of HU values in predicting PE. Results: The study population (N=74) consisted of a study group (N=46) and a control group (N=28). The sensitivity and specificity of HU value for predicting PE on thoracic CT were found 61.5% and 96.4% at a value of 54.8 (Area Under the Curve (AUC):0.690) for right main pulmonary artery; 65.0% and 96.4% at a value of 55.9 (AUC:0.736) for left main pulmonary artery; 44.4% and 96.4% at a value of 62.7 (AUC:0.615) for right interlobar artery; and 60.0% and 92.9% at a value of 56.7 (AUC:0.736) for left interlobar artery. Conclusion: HU values may exhibit high diagnostic specificity on CT, for thrombi up to the interlobar level. An HU value exceeding 54.8 up to the interlobar level may raise suspicion of the presence of PE.

A novel technique proposition for determining the resection margins in lung resection by using a thermal camera.

OBJECTIVES: Determination of resection margins is very important in anatomical lung resections for both oncologic outcomes and postoperative complications. Absence of intersegmental plans naturally in segmentectomy surgeries and presence of incomplete fissure variationally in pulmonary lobectomy procedures constitute a challenge for surgeons in determining resection margins. Thoracic surgeons can prefer various techniques such as inflation deflation method, indocyanine green imaging, and three-dimensional segment modeling to cope with this problem. These techniques have some disadvantages such as high cost, the necessity of intravenous drug administration, need for an additional imaging system and ineffectiveness due to emphysema, anthracotic lung surface or interalveolar pores. Here we studied an alternative method for the solution of these disadvantages and aimed to demonstrate the correctness of a hypothesis based on detecting the cooling of the ischemic lung portion by a thermal camera after dividing the related pulmonary artery. METHODS: We planned determining margins of resection with a thermal camera in patients scheduled for pulmonary lobectomy or segmentectomy. We made some measurements and mapping with a thermal camera before and after the dividing of pulmonary artery of related lobe or segment then processed the images taken with a software on the computer. RESULTS: We detected a significant decrease in temperature in the ischemic lung area and demonstrated mapping the demarcation line between ischemic and perfused areas effectively by thermography in a total of 32 patients underwent lung resection. CONCLUSION: Pulmonary resection margins can be detected effectively by thermography in patients.

Revealing an Iranian Isolate of Tomato Brown Rugose Fruit Virus: Complete Genome Analysis and Mechanical Transmission.

An analysis of the complete genome sequence of a novel isolate of tomato brown rugose fruit virus (ToBRFV) obtained from tomatoes in Iran and named ToBRFV-Ir is presented in this study. Comprehensive phylogenetic analysis utilizing key viral proteins, including 126 KDa, 183 KDa, movement protein (MP), and coat protein (CP), as well as the complete genome sequence, classified ToBRFV-Ir and 65 isolates from GenBank into three distinct clades. Notably, genetic diversity assessment revealed relatively low variability among the isolates, irrespective of their geographical or clade affiliation. Natural selection analysis based on the complete genome sequence showed that dN/dS values were consistently <1, indicating the prevailing role of negative selection across all populations. Analyses using the Recombination Detection Program and SplitsTree found no evidence of recombination events or signals in the complete genome sequence of the tested isolates. Thus, these results suggest that the genetic composition of ToBRFV remains stable without significant genetic exchange or recombination events occurring. A simple arithmetic comparison of the patristic distances and dates suggested that the time to the most recent common ancestor (TMRCA) of the ToBRFV populations is approximately 0.8 up to 2.7 with the closest tobamoviruses. An evolutionary study of the tested isolates from various countries based on the complete genome suggests Peruvian ancestry. The ToBRF-Ir isolate was successfully transmitted through mechanical inoculations to Solanum lycopersicum and Nicotiana rustica. These findings shed light on the genetic dynamics and transmission mechanisms of ToBRFV, providing valuable insights into its molecular characteristics and potential spread among susceptible plant species.

Predictors of static and dynamic balance control in kidney transplant recipients.

BACKGROUND: We aimed to evaluate balance control and lower extremity muscle strength in kidney transplant recipients (KTRs) including a comparison to a healthy control group and determine the predictors of static and dynamic balance control after kidney transplantation. METHODS: In this study 40 KTRs and 40 healthy controls were included. Balance control was assessed using the Biodex balance system. The static postural stability test (SPST) and clinical test of sensory integration and balance (CTSIB) were used to assess static balance control whereas the dynamic postural stability test (DPST) and limits of stability test (LOST) were used for dynamic balance control. Lower extremity muscle strength was measured with a hand-held dynamometer. Renal functions and laboratory findings of KTRs were recorded. RESULTS: All the stability index scores of SPST and sway index in CTSIB were significantly higher in KTRs compared to healthy controls. The right anteroposterior stability index score in DPST and the reaction time in LOST were significantly higher whereas overall score in LOST and lower extremity muscle strength were significantly lower in KTRs. The linear regression analysis revealed that hemoglobin was the predictor of static balance control accounting for 11% of the variance and body weight was the predictor of dynamic balance control accounting for 34% of the variance. CONCLUSION: Balance control, both static and dynamic, are impaired in KTRs as well as lower extremity muscle strength. Hemoglobin level is a predictor of static balance control whereas body weight is a predictor of dynamic balance control after kidney transplantation.

First complete sequences and genetic variation of plum pox virus T strain in Prunus dulcis and Prunus cerasus.

The complete genome of plum pox virus strain T isolates from five different Prunus spp., including almond (P. dulcis) and sour cherry (P. ceracus) isolates, was fully sequenced using the primer pairs designed in this study. The five isolates were aligned with other 50 PPV-T isolates whose complete genome sequences were available in GenBank and then subjected to phylogenetic and diversity analyses. Recombination analysis showed no significant signal detected in the five newly sequenced isolates while confirming four recombinant isolates reported in a previous study. Nucleotide and amino acid phylogenetic trees clustered the tested isolates into three major groups: Balkan 1, 2, and 3. Strain T isolates shared high nucleotide and amino acid identities among them. Diversity analysis applied different parameters to found that the sequences of P3 and 6K1 genes were more conserved over other genes. In accordance, the highly variable P1 and CP genes were found to experience weaker purifying pressures, ω = 0.127 and 0.219, respectively, than other genes. The three neutrality tests gave negative values to all genes, suggesting that strain T populations have expanding or bottleneck selections. Genetic make-up of the only known sour cherry isolate is highly identical to isolates from other Prunus spp. Therefore, this study has updated our knowledge of T strain diversity in new hosts and provided a clear picture of genetic variation and host relationships. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03746-1.

Is tumor diameter a risk factor for occult N1 metastasis in patients with peripheral non-small cell lung cancer which is smaller than 3 cm?

The optimum treatment option is surgery for clinical early stage non-small cell lung cancer. Despite all non-invasive and invasive staging effort, occult lymph-node metastasis can be detected in pathological staging. Here, we investigated whether there was any correlation between tumor diameter and occult lymph-node metastasis in N1 stations. Data of patient with non-small cell lung cancer clinical stage 1A were reviewed retrospectively. Those with tumor diameter smaller than 3 cm and pN0-pN1 in pathological staging were included in the study. Overall survival (OS) was calculated by Kaplan-Meier and survival differences between pN0 and pN1 groups were investigated by Log-Rank methods. Cut-off value of tumor diameter for lymph-node metastasis was investigated by Receiver-Operating Characteristics test. Significance between pN0-pN1 and other categorical groups was investigated with Pearson Chi-square or Fisher's exact tests. A total of 257 patients meet to criteria included in the study. Fifty-five (21.4%) of the patients were females. The mean age was 62.7 ± 8.5 and median tumor diameter was 20 mm (Range: 2-30 mm). We detected occult lymph-node metastasis at the N1 stations (pN1) in 33 patients (12.8%) in histopathological examination of resected specimens and lymph-node dissection materials. The cut-off value of tumor diameter was calculated as 21.5 mm for occult lymph-node metastasis by Receiver-Operating Characteristics analysis (Area Under Curved: 70.1%, p = 0.004). There was a significant correlation between pN1 positivity and high tumor diameter (p = 0.02). However, we did not find a correlation between the lymph-node metastasis and age, gender, tumor histopathology, tumor localization, and visceral pleural invasion. Tumor diameter may be an indicator for occult lymph-node metastasis in patients with clinical stage-1A non-small cell lung cancer. This result should be considered in patient with mass which larger than 21.5 mm and planned stereotactic body radiotherapy instead of surgery.

Global Population Structure of Apple Mosaic Virus (ApMV, Genus Ilarvirus).

The gene sequence data for apple mosaic virus (ApMV) in NCBI GenBank were analyzed to determine the phylogeny and population structure of the virus at a global level. The phylogenies of the movement protein (MP) and coat protein (CP) genes, encoded by RNA3, were shown to be identical and consisted of three lineages but did not closely correlate with those of P1 and P2, suggesting the presence of recombinant isolates. Recombination Detection Program (RDP v.4.56) detected significant recombination signal in the P1 region of K75R1 (KY883318) and Apple (HE574162) and the P2 region of Apple (HE574163) and CITH GD (MN822138). Observation on several diversity parameters suggested that the isolates in group 3 had higher divergence among them, compared to isolates in groups 1 and 2. The neutrality tests assigned positive values to P1, indicating that only this region experiencing balanced or contracting selection. Comparisons of the three phylogroups demonstrated high Fixation index (FST) values and confirmed genetic separation and the lack of gene flow among them. Additionally, ±500 bp of partial MP + 'intergenic region' + partial CP coding regions of two Turkish isolates from apple and seven from hazelnut were sequenced and determined that their phylogenetic positions fell within group 1 and 3, respectively.

The role of repeated extended FAST in patients with stable blunt thoracoabdominal trauma.

BACKGROUND: Thoracic and abdominal computed tomography scans are widely used modalities for trauma patients in emergency department (ED). However, alternative diagnostic and follow-up tools are also needed, due to limitations such as high cost and exces-sive radiation exposure. This study aimed to investigate the utility of repeated extended focused abdominal sonography for trauma (rE-FAST) performed by the emergency physician in patients with stable blunt thoracoabdominal trauma. METHODS: This was a prospective, single-center diagnostic accuracy study. Patients with blunt thoracoabdominal trauma admitted to the ED were included in the study. The E-FAST was performed on the patients included in the study at the 0th h, the 3rd h, and the 6th h during their follow-up. Then, the diagnostic accuracy metrics of E-FAST and rE-FAST were calculated. RESULTS: The sensitivity and specificity of E-FAST in determining thoracoabdominal pathologies were found to be 75% and 98.7%, respectively. The sensitivity and specificity for specific pathologies were 66.7% and 100% for pneumothorax, 66.7% and 98.8% for hemothorax, and 66.7% and 100% for hemoperitoneum, respectively. The sensitivity and specificity of rE-FAST in determining thoracal and/or abdominal hemorrhage in stable patients were found to be 100% and 98.7%, respectively. CONCLUSION: E-FAST successfully rules in thoracoabdominal pathologies in patients with blunt trauma, with its high specificity. However, only a rE-FAST might be sensitive enough to exclude traumatic pathologies in these stable patients.

Molecular Analysis of the Global Population of Potato Virus S Redefines Its Phylogeny, and Has Crop Biosecurity Implications.

In 2020, 264 samples were collected from potato fields in the Turkish provinces of Bolu, Afyon, Kayseri and Nigde. RT-PCR tests, with primers which amplified its coat protein (CP), detected potato virus S (PVS) in 35 samples. Complete CP sequences were obtained from 14 samples. Phylogenetic analysis using non-recombinant sequences of (i) the 14 CP's, another 8 from Tokat province and 73 others from GenBank; and (ii) 130 complete ORF, RdRp and TGB sequences from GenBank, found that they fitted within phylogroups, PVSI, PVSII or PVSIII. All Turkish CP sequences were in PVSI, clustering within five subclades. Subclades 1 and 4 were in three to four provinces, whereas 2, 3 and 5 were in one province each. All four genome regions were under strong negative selection constraints (ω = 0.0603-0.1825). Considerable genetic variation existed amongst PVSI and PVSII isolates. Three neutrality test methods showed PVSIII remained balanced whilst PVSI and PVSII underwent population expansion. The high fixation index values assigned to all PVSI, PVSII and PVSIII comparisons supported subdivision into three phylogroups. As it spreads more readily by aphid and contact transmission, and may elicit more severe symptoms in potato, PVSII spread constitutes a biosecurity threat for countries still free from it.

Partial Nephrectomy Due to Renal Cell Carcinoma in a Patient Who Was a Prior Kidney Donor: Pitfalls About Living Kidney Donation, Case Report, and Review of the Literature.

Cancer development in the remnant kidney in living kidney donors represents a challenging process in terms of patient management. Total nephrectomy is the preferred method for tumors exceeding 7 cm in size. In the case presented here, partial nephrectomy was preferred because the patient was a prior living kidney donor. On the other hand, being an organ donor always creates concerns for long-term safety and survival. The guidelines on the evaluation and care of living kidney donors have generally focused on assessment of the risk for chronic kidney disease in donors and donor-to-recipient infection or cancer transmission. In this case report, we also evaluated whether being a donor is a facilitating factor for cancer development in the remnant kidney.

A novel study on bean common mosaic virus accumulation shows disease resistance at the initial stage of infection in Phaseolus vulgaris.

Accurate and early diagnosis of bean common mosaic virus (BCMV) in Phaseolus vulgaris tissues is critical since the pathogen can spread easily and have long-term detrimental effects on bean production. The use of resistant varieties is a key factor in the management activities of BCMV. The study reported here describes the development and application of a novel SYBR Green-based quantitative real-time PCR (qRT-PCR) assay targeting the coat protein gene to determine the host sensitivity to the specific NL-4 strain of BCMV. The technique showed high specificity, validated by melting curve analysis, without cross-reaction. Further, the symptoms development of twenty advanced common bean genotypes after mechanical BCMV-NL-4 infection was evaluated and compared. The results showed that common bean genotypes exhibit varying levels of host susceptibility to this BCMV strain. The YLV-14 and BRS-22 genotypes were determined as the most resistant and susceptible genotypes, respectively, in terms of aggressiveness of symptoms. The accumulation of BCMV was analyzed in the resistant and susceptible genotypes 3, 6, and 9 days following the inoculation by the newly developed qRT-PCR. The mean cycle threshold (Ct) values showed that the viral titer was significantly lower in YLV-14, which was evident in both root and leaf 3 days after the inoculation. The qRT-PCR thus facilitated an accurate, specific, and feasible assessment of BCMV accumulation in bean tissues even in low virus titers, allowing novel clues in selecting resistant genotypes in the early stages of infection, which is critical for disease management. To the best of our knowledge, this is the first study of a successfully performed qRT-PCR to estimate BCMV quantification.

Typical Carcinoid Tumor Cases Causing Ectopic ACTH Syndrome: Dramatic Response to Surgery.

Although Cushing's Syndrome (CS) is usually caused by pituitary/adrenal adenomas, in the remaining few cases, Adrenocorticotrophic hormone (ACTH) is secreted by extrapituitary neuroendocrine tumors (NET). In typical pulmonary / bronchial carcinoid tumors leading to ectopic ACTH syndrome (EAS). The main principle of treatment is the localization of the ACTH-secreting tumor and its surgical removal. In this case report, we aimed to present two typical carcinoid cases, whose ACTH and cortisol levels returned to normal after lung surgery for ectopic ACTH. One of the cases, a 32-year-old female patient with CS symptoms and signs, was referred to our department after detecting a lesion in the left lower lobe in the thorax CT, which did not show an obvious focus on cranial MRI. The other patient, a 36-year-old male, had previously undergone adrenalectomy for Cushing's syndrome and was admitted to the emergency department due to adrenal insufficiency. The lesion seen in the right lower lobe on thorax CT was evaluated as an ectopic ACTH focus. After the tumors of the patients were resected according to surgical principles, CS clinic regressed, and ACTH and cortisol values returned to normal. Pathological examinations of the surgically resected tumors were reported as typical carcinoid. With surgically removed typical carcinoids tumors, excellent longterm survival results can be achieved and hypercortisolism can be controlled.

The Role Of Serum Uric Acid And Uric Acid To Albumin Ratio For Predicting Of Lymph Node Metastasis In Lung Cancer Treated Surgically By Vats.

OBJECTIVES: In recent years, a correlation between prognosis of various cancers and inflammation has been emphasized in many studies. Uric acid which is a purine metabolite is one of the serum inflammation markers. Albumin is a major component of serum protein and it is used as a parameter reflecting nutritional status and cancer aggressiveness. Here, we have investigated whether preoperative serum uric acid levels, albumin levels, and uric acid to albumin ratio predict lymph node metastasis in non-small cell lung cancer treated surgically by VATS. METHODS: The medical records of patients underwent VATS lobectomy-segmentectomy for non-small cell lung cancer between January 2015 and December 2020, were reviewed retrospectively. Cut-off values of preoperative serum uric acid, albumin and uric acid to albumin ratio were determined by Receiver Operating Characteristics (ROC) analysis. Groups with and without lymph node metastasis were created according to hilar and/or mediastinal lymph node metastasis. In addition, high and low groups were created according to preoperative uric acid levels and uric acid to albumin ratio. Pearson chi-square test was used investigate whether any significant correlation between the groups. RESULTS: A total of 115 patients were included in the study. Lymph node metastasis in N1 and N2 stations was detected in 11 and 18 patients, respectively. Cut-off values for uric acid and uric acid to albumin ratio were 5.97 mg/dL and 1.28x10-3, respectively. There was a statistically significant correlation between lymph node metastasis and high uric acid levels (p=0.008, OR: 3.2) and high uric acid to albumin ratio (p=0.03, OR: 2.6). CONCLUSION: Preoperative serum uric acid and uric acid to albumin ratio can predict the lymph node metastasis in non-small cell lung cancer treated surgically by video assisted thoracic surgery.

Oxidized Regenerated Cellulose can be a Cause of False Tumor Recurrence on PET/CT in Patients with Lung Cancer Treated Surgically.

Objectives: Regular follow-up of patients with lung cancer treated surgically is crucial to detect local recurrence or distant metastasis of the tumor. Postoperative follow-ups are performed with thorax computed tomography (CT) and, if necessary, positron emission tomography (PET)/CT. Sometimes, inflammatory tissue reactions due to the materials used during the surgery for hemostasis may cause the appearance of tumor recurrence in imaging modalities. In this study, we presented that oxidized regenerated cellulose (ORC) used intraoperatively may cause false tumor recurrence on PET/CT. Methods: The records of patients who had local tumor recurrence after lung cancer surgery was reviewed retrospectively. Inclusion criteria were the presence of local recurrence of cancer on PET/CT, specification of using ORC in the surgical notes, and histopathological diagnosis of the recurrence site of tumor was reported as a foreign body reaction. Data of patients were collected according to age, gender, surgery performed, adjuvant therapy status, resolution status and time ORC, and standard uptake value of 18F-fluorodeoxyglucose on PET/CT. Results: Eleven patients (1 female, 10 males) who met the criteria were included in the study. The median age was 64. Histopathological results of all patients were reported as foreign body reactions. The median detection time of PET/CT positivity after surgery was 139 days (range: 52-208 days). False tumor recurrence was resolved in 8 patients (72.7%) in their control radiological examinations and median resolution time was 334 days (range: 222-762 days). The median maximum standard uptake value of the lesions was 6.2 (1.7-11) on the PET/CT. Conclusion: ORC used intraoperatively in patients undergoing surgery for lung cancer may cause false tumor recurrence in imaging modalities in postsurgical follow-ups. When tumor recurrence is suspected in the follow-up of these patients, histopathological confirmation is necessary to prevent unnecessary operations and treatments.

Capital stock, energy, and innovation-related aspects as drivers of environmental quality in high-tech investing economies.

By looking at the technological advancement and climate change mitigation plan of the advanced economies, the current study examines the role of sustainable development aspects such as innovations, high technology export, labor productivity, capital stock, research and development (R&D), information and communication technology (ICT), capital stock, and energy use in mitigating environmental degradation for the selected panel of countries with the most investment in technology (China, Denmark, Finland, France, Israel, Korea, Hong Kong, Germany, Japan, Netherlands, Singapore, Sweden, United Kingdom, and United States) over the period 2000-2018. Foremost, the pooled ordinary least square (POLS) and random-effects (RE) generalized least squares (GLS) approaches provided additional interesting inferences. As such, the POLS result revealed that only capital stock in the panel countries shows a desirable environmental effect. At the same time, labor productivity, innovation, R&D, ICT, and energy further hamper ecological quality in the examined panel countries. Similarly, the GLS result largely affirms the POLS results, with only the capital stock among the explanatory variables showing evidence of emission mitigation effect in the panel. Additionally, the panel Granger causality result illustrates evidence of unidirectional causality only innovation, ICT, and capital stock to environmental degradation.

Long-Term Outcomes of Patients With Amyloidosis Following Kidney Transplant.

OBJECTIVES: Reported graft and patient survival rates in amyloidosis after renal transplant differ considerably between studies. MATERIALS AND METHODS: Group 1 included 24 patients who had end-stage renal disease secondary to amyloidosis. Group 2 (the control group) included 24 consecutive patients who had kidney disease secondary to various causes other than amyloidosis. Comparisons between groups were made for kidney and patient survival rates and other complications following kidney transplant. We also compared survival rates of patients in group 1 versus another control group that included patients with amyloidosis who were treated with hemodialysis (group 3; n = 25). RESULTS: Mean follow-up was 109.5 ± 79.8 months. Biopsy-proven acute rejection and graft failure rates were not significantly different between groups. In group 1 versus group 2, the cumulative 10-year and 20-year patient survival rates were 68.2% versus 86.1% and 36.9% versus 60.3%, respectively (P = .041). Survival was not significantly different in group 1 compared with group 2 and group 3, although patients in group 3 had significantly shorter duration of time to death after the start of renal replacement therapy. CONCLUSIONS: Patient survival may be lower in kidney transplant recipients with amyloidosis compared with patients with end-stage renal disease due to other causes. However, graft failure and acute rejection rates seem to be similar.

Validation of Inflammatory Prognostic Biomarkers in Pleural Mesothelioma.

Evoked from asbestos-induced inflammation, pleural mesothelioma represents a fatal diagnosis. Therapy ranges from nihilism to aggressive multimodality regimens. However, it is still unclear who ultimately benefits from which treatment. We aimed to re-challenge inflammatory-related biomarkers' prognostic value in times of modern immune-oncology and lung-sparing surgery. The biomarkers (leukocytes, hemoglobin, platelets, neutrophils, lymphocytes, monocytes, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP)) and clinical characteristics (age, sex, histology, therapy) of 98 PM patients were correlated to overall survival (OS). The median OS was 19.4 months. Significant OS advantages (Log-Rank) were observed in multimodal treatment vs. others (26.1 vs. 7.2 months, p < 0.001), surgery (pleurectomy/decortication) vs. no surgery (25.5 vs. 3.8 months, p < 0.001), a high hemoglobin level (cut-off 12 g/dL, 15 vs. 24.2 months, p = 0.021), a low platelet count (cut-off 280 G/L, 26.1 vs. 11.7 months, p < 0.001), and a low PLR (cut-off 194.5, 25.5 vs. 12.3 months, p = 0.023). Histology (epithelioid vs. non-epithelioid, p = 0.002), surgery (p = 0.004), CRP (cut-off 1 mg/dL, p = 0.039), and platelets (p = 0.025) were identified as independent prognostic variables for this cohort in multivariate analysis (Cox regression, covariates: age, sex, histology, stage, CRP, platelets). Our data verified the previously shown prognostic role of systemic inflammatory parameters in patients treated with lung-sparing surgery within multimodality therapy.