title: Predictors of survival in patients with non-small cell lung cancer.
abstract: OBJECTIVE
  To examine how routine laboratory biomarkers and clinical parameters available within medical records related to overall survival in patients with non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  University-based cancer center in rural West Virginia.
  
  
  METHODS
  110 patients from the U.S. Appalachian region with a primary diagnosis of NSCLC at initial hospitalization.
  
  
  METHODS
  Electronic medical records were reviewed for one year after discharge or until death. The Kaplan-Meier method was used to compare survival curves for each prognostic factor. Cox proportional hazards model was used for multivariate analyses.
  
  
  METHODS
  Total white blood cell, neutrophil, lymphocyte, and platelet counts; hemoglobin level; body mass index (BMI); performance status; and cancer stage.
  
  
  RESULTS
  Low BMI (lower than 18.5 lb/in2), advanced cancer stage (IIIB or IV), and elevated neutrophil (higher than 8 x 103/mcl) and platelet (300-826 x 1012/L) counts were significant, independent prognostic factors for shorter survival time in NSCLC. BMI (hazard ratio [HR] = 2.15, 95% confidence interval [CI] [0.94, 4.9]) and neutrophil (HR = 2.93, 95% CI [1.53, 5.59]) and platelet (HR = 2.65, 95% CI [1.25, 5.62]) counts were overall prognostic predictors for patients with advanced NSCLC and remained in the multivariate survival model.
  
  
  CONCLUSIONS
  This study detected two known clinical parameters, cancer stage and nutritional status (i.e., BMI and neutrophil and platelet counts), as having independent prognostic significance for shorter survival in NSCLC. Research on survival in patients with NSCLC should include those identified laboratory biomarkers and clinical parameters for screening patients at risk for shorter survival time following hospitalization. Investigation of whether treatments tailored to address neutrophil and platelet counts and BMI can improve survival outcomes also is warranted.
  
  
  CONCLUSIONS
  Attention to common biomarkers recorded in patient charts (e.g., neutrophil and platelet counts) as well as BMI could allow nurses to identify patients at risk for low survival. Interventions should be identified and initiated. Longitudinal studies in clinical settings that follow the survival of patients with NSCLC are essential.
authors.affiliation: School of Public Health and the Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV, USA.
authors.forename: Juhua
authors.initials: J
authors.lastname: Luo
authors.forename: Yea-Jyh
authors.initials: YJ
authors.lastname: Chen
authors.forename: Georgia L
authors.initials: GL
authors.lastname: Narsavage
authors.forename: Alan
authors.initials: A
authors.lastname: Ducatman
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate