Lung cancer symptoms and pulse oximetry in the prognostic assessment of patients with lung cancer.
BACKGROUND
Medical oncologists continue to use performance status as a proxy for quality of life (QOL) measures, as completion of QOL instruments is perceived as time consuming, may measure aspects of QOL not affected by cancer therapy, and interpretation may be unclear. The pulse oximeter is widely used in clinical practice to predict cardiopulmonary morbidity after lung resection in cancer patients, but little is known on its role outside the surgical setting. We evaluated whether the Lung Cancer Symptom Scale and pulse oximetry may contribute to the evaluation of lung cancer patients who received standard anticancer therapy.


METHODS
We enrolled forty-one consecutive, newly diagnosed, patients with locally advanced or metastatic lung cancer in this study. We developed a survival model with the variables gender, age, histology, clinical stage, Karnofsky performance status, wasting, LCSS symptom scores, average symptom burden index, and pulse oximetry (SpO2).


RESULTS
Patient and observer-rated scores were correlated, except for the fatigue subscale. The median SpO2 was 95% (range: 86 to 98), was unrelated to symptom scores, and was weakly correlated with observer cough scores. In a multivariate survival model, SpO2 > 90% and patient scores on the LCSS appetite and fatigue subscales were independent predictors of survival.


CONCLUSIONS
LCSS fatigue and appetite rating, and pulse oximetry should be studied further as prognostic factors in lung cancer patients.
Pulmonary Division, University of São Paulo Medical School, Av. Dr. Arnaldo 455, 01246-903 São Paulo, Brazil. sjmartins@yahoo.com
Sandro J
SJ
Martins
Nelson
N
Ho
Sueli O
SO
Cavamura
Cecilia M
CM
Harada
Crystina A
CA
Yamamoto
Teresa Y
TY
Takagaki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000494:pharmacology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D010092:Oximetry / Q000379:methods*; D011379:Prognosis; D016016:Proportional Hazards Models; D012907:Smoking; D013997:Time Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents