İlkay ÇITAKKUL, Yasemin BAKKAL TEMİ, Hilmi ZENGİN, Mertcan ÖNEN, Ece BAYDAR, Umut KEFELİ, Devrim ÇABUK, Kazım UYGUN
Journal of Current Hematology & Oncology Research - 2026;4(2):63-69
Aims : Pleural mesothelioma is an aggressive malignancy with poor prognosis and limited therapeutic options. Reliable prognostic models are essential for risk stratification and clinical decision-making. The recently developed PLACE score has shown promising results in Chinese populations; however, its generalizability remains uncertain. This study aimed to externally validate the PLACE prognostic score in a Turkish cohort of patients with metastatic epithelioid pleural mesothelioma. Methods : This retrospective cohort study included patients diagnosed with metastatic epithelioid pleural mesothelioma at a single tertiary center between January 2016 and September 2025. Clinical and laboratory data at diagnosis were collected, and the PLACE score was calculated for each patient. Overall survival (OS) was analyzed using the Kaplan-Meier method, and differences between risk groups were compared using the log-rank test. Cox proportional hazards regression analysis was performed to evaluate the association between prognostic variables and survival. The discriminative ability of the PLACE score was assessed using receiver operating characteristic (ROC) curve analysis. Results : A total of 48 patients were included, with a median age of 66 years. According to the PLACE score, 33.3% of patients were classified as low-risk and 66.7% as high-risk. The median OS was 21.06 months. Patients in the low-risk group had significantly longer survival compared to the high-risk group (37.98 vs. 15.6 months, p=0.033). Time-dependent ROC analysis demonstrated increasing discriminative ability over time, with AUC values ranging from 0.554 at 6 months to 0.717 at 24 months. In Cox regression analysis, high-risk patients had a significantly increased risk of mortality (HR: 2.28, 95% CI: 1.04-4.95, p=0.037). In multivariable analysis, the PLACE risk group remained significantly associated with OS. Conclusion : The PLACE score retains prognostic significance in Turkish patients with metastatic pleural mesothelioma but demonstrates reduced discriminative performance compared to the original study. These findings emphasize the need for external validation and potential population-specific recalibration of prognostic models.
