Abstract
Prognostic factors which can forecast short‐term survival in patients with stage IV non‐small cell lung cancer have not been well evaluated. Characteristics of such factors may be different from those for overall survival, and would be an important eligibility criterion for clinical trials of chemotherapy. We retrospectively analyzed the data of 158 patients with stage IV non‐small cell lung cancer whose performance status was 0, 1 or 2. Univariate and multivariate logistic regression models revealed demographic variables which significantly correlated with the survival at 8 or 12 weeks. The univariate model showed the following significant variables: T factor, N factor, number of organs with metastases, grade of performance status, weight loss within 6 months, evidence of metastasis either at bone or lymph node, and lactate dehydrogenase level. The subsequent multivariate model demonstrated that both grade of performance status under 2 and number of metastasized organs less than 3 are important factors for 8‐ or 12‐week survival. The survival rate in patients meeting the two criteria (grade of performance status under 2 and number of metastasized organs less than 3) and in those meeting only one of them was 93% versus 80% at 8 weeks (P=0.030) and 88% versus 62% at 12 weeks (P<0.001), respectively. Grade of performance status and number of organs with metastases appear to be important prognostic factors for short‐term survival in patients with stage IV non‐small cell lung cancer.
Keywords: Metastasis Minimum life expectancy, Non‐small cell lung cancer, Performance status, Metastasis
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REFERENCES
- 1. ) Mountain , C. F.Revisions in the international system for staging lung cancer . Chest , 111 , 1710 – 1717 ( 1997. ). [DOI] [PubMed] [Google Scholar]
- 2. ) O'Connell , J. P. , Kris , M. G. , Gralla , R. J. , Groshen , S. , Trust , A. , Fiore , J. J. , Kelsen , D. P. , Heelan , R. T. and Golbey , R. B.Frequency and prognostic importance of pretreatment clinical characteristics in patients with advanced non‐small‐cell lung cancer treated with combination chemotherapy . J. Clin. Oncol. , 4 , 1604 – 1614 ( 1986. ). [DOI] [PubMed] [Google Scholar]
- 3. ) Sørensen , J. B. , Badsberg , J. H. and Olsen , J.Prognostic factors in inoperable adenocarcinoma of the lung: a multi‐variate regression analysis of 259 patients . Cancer Res. , 49 , 5748 – 5754 ( 1989. ). [PubMed] [Google Scholar]
- 4. ) Albain , K. S. , Crowley , J. J. , LeBlanc , M. and Livingston , R. B.Survival determinants in extensive‐stage non‐small‐cell lung cancer: the Southwest Oncology Group experience . J. Clin. Oncol. , 9 , 1618 – 1626 ( 1991. ). [DOI] [PubMed] [Google Scholar]
- 5. ) Shinkai , T. , Eguchi , K. , Sasaki , Y. , Tamura , T. , Ohe , Y. , Kojima , A. , Oshita , F. , Miya , T. , Okamoto , H. , Iemura , K. and Saijo , N.A prognostic‐factor risk index in advanced non‐small‐cell lung cancer treated with cisplatin‐containing combination chemotherapy . Cancer Chemother. Pharmacol. , 30 , 1 – 6 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 6. ) Finkelstein , D. M. , Ettinger , D. S. and Ruckdeschel , J. C.Long‐term survivors in metastatic non‐small‐cell lung cancer: an Eastern Cooperative Oncology Group Study . J. Clin. Oncol. , 4 , 702 – 709 ( 1986. ). [DOI] [PubMed] [Google Scholar]
- 7. ) Paesmans , M. , Sculier , J. P. , Libert , P. , Bureau , G. , Dabouis , G. , Thiriaux , J. , Michel , J. , Van Cutsem , O. , Sergysels , R. , Mommen , P. and Klastersky , J.Prognostic factors for survival in advanced non‐small‐cell lung cancer: univariate and multivariate analyses including recursive partitioning and amalgamation algorithms in 1,052 patients. The European Lung Cancer Working Party . J. Clin. Oncol. , 13 , 1221 – 1230 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 8. ) Leventhal , B. G. and Wittes , R. E.Phase I trials . In“Research Methods in Clinical Oncology ” pp. 41 – 59 ( 1988. ). Raven Press; , New York . [Google Scholar]
- 9. ) Evans , C. and McCarthy , M.Prognostic uncertainty in terminal care: can the Karnofsky index help ? Lancet , 1 , 1204 – 1206 ( 1985. ). [DOI] [PubMed] [Google Scholar]
- 10. ) Ihde , D. C.Chemotherapy of lung cancer . N. Engl. J. Med. , 327 , 1434 – 1441 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 11. ) Shepherd , F. A.Treatment of advanced non‐small cell lung cancer . Semin. Oncol. , 21 , 7 – 18 ( 1994. ). [PubMed] [Google Scholar]
- 12. ) Ruckdeschel , J. C. , Finkelstein , D. M. , Ettinger , D. S. , Creech , R. H. , Mason , B. A. and Vogl , S.A randomized trial of the four most active regimens for metastatic non‐small‐cell lung cancer . J. Clin. Oncol. , 4 , 14 – 22 ( 1986. ). [DOI] [PubMed] [Google Scholar]