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Nutritional Status and Tumor Thickness Helps Determine Mesothelioma Prognosis

Published: March 20, 2017

The overall nutritional health of a patient suffering from mesothelioma can have major impact on how the patient will respond to treatment, which affects patient survival. To determine a patient’s nutritional factors on a more exact basis, researchers and scientists from Japan used a scoring system called Controlling Nutritional Status score, or CONUT.

CONUT scores are calculated based upon the total levels of serum albumin (blood plasma protein), cholesterol, and lymphocyte (a subtype of white blood cells).The higher the score correlates to an overall poorer nutritional status.  Scientists and researchers out of Japan examined a total of 83 patients with both high and low CONUT scores and found that those with higher CONUT scores had significantly lower overall survival. While it may be obvious that those who are initially in better health have a better prognosis, knowing the CONUT score can be helpful in determining which patients will benefit most from certain treatment. The CONUT score can also be used when selecting participants for clinical trials. Building up the immune system benefits the patient so he/she can be more responsive to treatment. It is recommended to maintain diet in antioxidant-rich foods like fruit, vegetables, green tea, fiber, fish oil and lean proteins and avoid sugary, spicy, and fried food as these can upset the stomach.

Another way to optimize patient selection for clinical trials could lay in the results found by doctors at the University of Toronto who had found a correlation between tumor thickness and overall survival. Deciphering tumor thickness can help determine overall prognosis for mesothelioma patients, which can lead to customizing treatment options for those suffering from the asbestos-caused cancer.

Doctors examined 65 patients suffering from pleural mesothelioma that had yet to receive any sort of treatment and measured the total thickness of their mesothelioma tumors.  Maximum thickness was measured on nine specific locations on the chest wall, the diaphragm, and the membrane that separates the lungs. These same 65 patients went on to take part in a study called SMART, which included having surgery after rounds of radiation treatment.  After 19 months, patients were examined again and it was found that the 55% of those who had died during that time had the highest total tumor thickness.

Mesothelioma is a rare and aggressive cancer that is caused by asbestos exposure. The nature of the cancer makes it difficult to treat, and so clinical trials are a common treatment option. Determining the best candidates for specific clinical trials helps to improve and adjust the treatment, ultimately making it more universally successful.



De Perrot, Marc, et al, “Impact of Tumour Thickness On Survival After Radical Radiation And Surgery In Malignant Pleural Mesothelioma,” European Respiratory Journal (2017). [Link]

Takamori, S, et al, “The Controlling Nutritional Status Score is a Significant Independent Predictor of Poor Prognosis in Patients with Malignant Pleural Mesothelioma” Clinical Lung Cancer (February 2, 2017). [Link]

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