title: Factors associated with long-term survival of patients with advanced non-small cell lung cancer.
abstract: OBJECTIVE
  Only a small proportion of patients with advanced non-small cell lung cancer (NSCLC) have a life expectancy greater than 2 years. The aim of this study was to identify the factors associated with long-term survival of patients with advanced NSCLC.
  
  
  METHODS
  Patients who had received chemotherapy for stage IIIb or IV NSCLC that was not amenable to radiotherapy were studied retrospectively. Data were gathered prospectively from a comprehensive database. Long-term survivors (>2 years) were compared with the other patients, with respect to clinical, biological and tumour-node-metastasis criteria.
  
  
  RESULTS
  Data for 245 consecutive patients were collected. Thirty nine patients (15.9%) survived for more than 2 years. Long-term survivors were more likely to have had metastases at fewer sites (P = 0.008), an absence of bone metastases (P = 0.01), a performance status (PS) of 0-1 at first progression of the tumour (P = 0.002), a tumour that was controlled with first (P < 0.0001) and second-line (P = 0.004) chemotherapy, maintenance therapy (P = 0.001), curative surgery (P < 0.0001), time to first progression of the tumour of >3 months (P < 0.0001), normal LDH levels at diagnosis (P = 0.049), and a haemoglobin concentration >110 g/L at first progression of the tumour (P = 0.02). In multivariate analysis, surgery, maintenance treatment, time to first progression of the tumour of >3 months, a PS of 0-1 at first progression, the number of chemotherapy agents received, and LDH levels, were significant predictors of long-term survival.
  
  
  CONCLUSIONS
  Assessment of these factors, and the use of maintenance therapy, when possible, may identify a population of patients with NSCLC that is likely to have a prolonged life expectancy.
authors.affiliation: Thoracic Oncology Unit, Respiratory Diseases Department, Tenon Hospital, APHP and Paris VI University, Paris. etienne.giroux-leprieur@apr.aphp.fr
authors.forename: Etienne
authors.initials: E
authors.lastname: Giroux Leprieur
authors.forename: Armelle
authors.initials: A
authors.lastname: Lavole
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Ruppert
authors.forename: Valérie
authors.initials: V
authors.lastname: Gounant
authors.forename: Marie
authors.initials: M
authors.lastname: Wislez
authors.forename: Jacques
authors.initials: J
authors.lastname: Cadranel
authors.forename: Bernard
authors.initials: B
authors.lastname: Milleron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis