Tumor cell lines established in vitro: an independent prognostic factor for survival in non-small-cell lung cancer.
OBJECTIVE
To determine the relation between in-vitro establishment of tumor cell lines and survival in patients with non-small-cell lung cancer.


METHODS
Cohort study.


METHODS
Single-institution tertiary care center.


METHODS
One hundred twenty-three consecutive patients with non-small-cell lung cancer from whom a viable tumor specimen could be obtained.


METHODS
Tumor tissue was removed at the time of entry into a therapeutic protocol. The tumor tissue was processed in the laboratory for attempted cell-line establishment. Patients classified as potentially curable (stages I, II, and IIIA) were treated with surgical resection, radiation therapy, or a combination. Patients suitable for palliative therapy only (stages IIIB and IV) were treated with radiation therapy with or without chemotherapy. Chemotherapy was based on in-vitro drug sensitivity when available. Cell-line establishment was correlated to clinical outcome.


RESULTS
Univariate analysis of survival was done using the log-rank test; multivariate analysis was done by Cox modeling step-up and step-down techniques. Cell lines were established from the tumor specimens of 25 patients (20%). Those patients experienced a median survival of 7 months compared with 18 months in patients from whom cell lines could not be established (P less than 0.001). In the 61 patients with potentially curable disease, 8 patients (13%) with cell lines established had a median survival of 8 months compared with 32 months for those without cell lines established (P = 0.001). In the 62 palliative group patients, the median survival of the 17 patients (27%) from whom tumor cell lines were established was 5 months compared with 7 months for those without cell lines (P = 0.15). Multivariate analysis in both groups showed cell-line establishment to be a significant indicator of prognosis (P less than 0.0001 for curable group; P less than 0.01 for palliative group).


CONCLUSIONS
In-vitro tumor growth is related to decreased patient survival, which in turn reflects the biologic aggressiveness of cancers giving rise to these tumor cell lines.
Stevenson
H
H
National Cancer Institute, Bethesda, Maryland.
Gazdar
A F
AF
Phelps
R
R
Linnoila
R I
RI
Ihde
D C
DC
Ghosh
B
B
Walsh
T
T
Woods
E L
EL
Oie
H
H
O'Connor
T
T
D000704:Analysis of Variance; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002470:Cell Survival / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011379:Prognosis; D013223:Statistics as Topic; D015996:Survival Rate; D014407:Tumor Cells, Cultured / Q000166:cytology*
D007770:L-Lactate Dehydrogenase