The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer.
The relationship between the magnitude of systemic inflammatory response and the nutritional/functional parameters in patients with inoperable non-small cell lung cancer were studied. The extent of weight loss, albumin, C-reactive protein, performance status and quality of life was measured in 106 patients with inoperable non-small cell lung cancer (stages III and IV). Survival analysis was performed using the Cox proportional hazard model. The majority of patients were male and almost 80% had elevated circulating C-reactive protein concentrations (>10 mg x l(-1)). On multivariate analysis, age (P=0.012), tumour type (0.002), weight loss (P=0.056), C-reactive protein (P=0.047), Karnofsky performance status (P=0.002) and fatigue (P=0.046) were independent predictors of survival. The patients were grouped according to the magnitude of the C-reactive protein concentrations (< or =10, 11-100 and >100 mg x l(-1)). An increase in the magnitude of the systemic inflammatory response was associated with increased weight loss (P=0.004), reduced albumin concentrations (P=0.001), reduced performance status (P=0.060), increased fatigue (P=0.011) and reduced survival (HR 1.936 95%CI 1.414-2.650, P<0.001). These results indicate that the majority of patients with inoperable non-small cell lung cancer have evidence of a systemic inflammatory response. Furthermore, an increase in the magnitude of the systemic inflammatory response resulted in greater weight loss, poorer performance status, more fatigue and poorer survival.
Scott
H R
HR
Department of Respiratory Medicine, Wishaw General Hospital, Lanarkshire ML 0DP, UK.
McMillan
D C
DC
Forrest
L M
LM
Brown
D J F
DJ
McArdle
C S
CS
Milroy
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000401:mortality* / Q000523:psychology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000401:mortality* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications*; D015431:Weight Loss
D002097:C-Reactive Protein