title: The prognostic value of the simplified comorbidity score in the treatment of small cell lung carcinoma.
abstract: BACKGROUND
  Comorbidity may be an important prognostic factor in the treatment of small cell lung carcinoma (SCLC). This study aimed to investigate the prognostic values of simplified comorbidity score (SCS) in the treatment of patients with SCLC.
  
  
  METHODS
  The patients with SCLC admitted to the National Taiwan University Hospital during the period from January 2000 to December 2006 were included. The medical records were reviewed and analyzed. The SCS was used to evaluate comorbidities of the patients. A Cox proportional hazard model was used to calculate the hazard ratio (HR) and 95% confidence intervals (CIs) for age, gender, and factors significantly associated with survival identified in univariate analyses.
  
  
  RESULTS
  A total of 172 patients were included; 56 patients had limited-stage disease and 116 had extensive-stage disease. Patients with an SCS more than 9 had shorter overall survival than those with SCS ≤ 9 both in limited-stage (372 days versus 581 days, p = 0.01) and extensive-stage disease (215 days versus 324 days, p = 0.001). Multivariate analysis indicated that SCS more than 9 was associated with a worse prognosis in patients with limited-stage disease (HR: 2.17, 95% CI: 1.12-4.21) and extensive-stage disease (HR: 1.74, 95% CI: 1.12-2.72), respectively. For patients with extensive-stage disease, SCS more than 9 was associated with poor treatment response (> 9 versus ≤ 9, disease response rate: 60.0% versus 82.4%, p = 0.02).
  
  
  CONCLUSIONS
  The SCS may be an independent prognostic factor for patients with SCLC. Large-scale prospective studies may be required to validate the prognostic value of the SCS for SCLC.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taipei, Taiwan.
authors.forename: Yao-Wen
authors.initials: YW
authors.lastname: Kuo
authors.forename: Jih-Shuin
authors.initials: JS
authors.lastname: Jerng
authors.forename: Jin-Yuan
authors.initials: JY
authors.lastname: Shih
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Chen
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
authors.forename: Pan-Chyr
authors.initials: PC
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D015996:Survival Rate; D013624:Taiwan