The Prognostic Significance of Glucose Transporter-1 Protein in Malignant Pleural Mesothelioma

INTRODUCTION: Malignant pleural mesothelioma (MPM) is a rare condition with a poor survival rate. This study was designed to determine the prognostic importance of glucose transporter-1 (GLUT-1) expression in operated patients with pleural mesothelioma.
METHODS: Patients operated with a diagnosis of pleural mesothelioma between January 2005 and September 2014 were retrospectively analyzed in terms of age, gender, diagnosis method, maximum standardized uptake value in positron emission tomography, operation, pathology, GLUT-1 expression in the specimen, morbidity, and mortality.
RESULTS: One hundred and twenty-nine patients were diagnosed as MPM. 75 (54 male and 21 female) of these patients underwent therapeutic operations. The mean age was 63 (range 41–89). Extrapleural pneumonectomy was performed in 27, pleurectomy/decortication in 25, and radical pleurectomy in 23 patients. The pathological diagnosis was epithelial in 67 and biphasic in 8 patients. All the patients were referred for adjuvant chemoradiotherapy and 69% completed the intended trimodality treatment. In 61 (81.3%) of the operated patients, the parietal pleura material was positive for GLUT-1. The morbidity was seen in 16 of the operated patients. The average survival time was 23.7 months after surgery. The average survival time was 24.5 months in patients with GLUT-1 expression <10% in extent, and 15.6 months in rest of the patients (p=0.001).
DISCUSSION AND CONCLUSION: MPM has a poor prognosis even after surgery. However, lower expression of GLUT-1 was associated with significantly longer survival in our study. The survival time was found to be better if the GLUT-1 extent was <10%. Larger studies are needed to prove the prognostic significance of GLUT-1.