Survival and prognostic factors in small cell lung cancer.
The purposes of this study were to evaluate the treatment outcome of patients with small cell lung cancer (SCLC), focusing on the prognostic factors for response to therapy and overall survival. A retrospective analysis was performed on 116 consecutive patients with SCLC diagnosed from January 1997 to December 2005. Collected data included demographic information, pretreatment clinical assessment, treatment regimen, and outcome information. Prognostic factors were analyzed by log-rank test and Cox regression model. Results showed that performance status (PS) 0-1, limited disease, normal serum carcinoembryonic antigen (CEA), and vascular endothelial growth factor (VEGF) level were associated with improved response rate. The univariate analysis showed that sex, disease extent, PS, serum CEA, and VEGF level significantly influenced overall survival. In multivariate analysis, disease extent, PS, serum CEA, and VEGF level were identified as independent prognostic factors. In addition, prophylactic cranial irradiation (PCI) and number of metastatic sites were independent prognostic factors in limited disease and extensive disease, respectively. We concluded that disease extent, PS, serum CEA, and VEGF level are strong predictors of both response and survival. Female sex was a favorable prognostic factor for survival. Moreover, the prognostic factors for limited disease were good PS, normal serum CEA and VEGF level, and PCI, the prognostic factors for extensive disease were good PS, one metastatic site, normal serum CEA, and VEGF level. The identification of prognostic factors may be useful for the better evaluation of treatment outcome in clinical trials and the use of a targeted and specific treatment.
Li
Jian
J
Department of Pulmonary Medicine, Affiliated Hospital of Jiangsu University, Jiangsu, China. lijian541226@163.com
Dai
Chun-Hua
CH
Chen
Ping
P
Wu
Jian-Nong
JN
Bao
Quan-Lei
QL
Qiu
Hao
H
Li
Xiao-Qin
XQ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000032:analysis / Q000097:blood; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D055752:Small Cell Lung Carcinoma / Q000097:blood / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis / Q000097:blood
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D042461:Vascular Endothelial Growth Factor A