title: A new scoring system for predicting survival in patients with non-small cell lung cancer.
abstract: This analysis was performed to create a scoring system to estimate the survival of patients with non-small cell lung cancer (NSCLC). Data from 1274 NSCLC patients were analyzed to create and validate a scoring system. Univariate (UV) and multivariate (MV) Cox models were used to evaluate the prognostic importance of each baseline factor. Prognostic factors that were significant on both UV and MV analyses were used to develop the score. These included quality of life, age, performance status, primary tumor diameter, nodal status, distant metastases, and smoking cessation. The score for each factor was determined by dividing the 5-year survival rate (%) by 10 and summing these scores to form a total score. MV models and the score were validated using bootstrapping with 1000 iterations from the original samples. The score for each prognostic factor ranged from 1 to 7 points with higher scores reflective of better survival. Total scores (sum of the scores from each independent prognostic factor) of 32-37 correlated with a 5-year survival of 8.3% (95% CI = 0-17.1%), 38-43 correlated with a 5-year survival of 20% (95% CI = 13-27%), 44-47 correlated with a 5-year survival of 48.3% (95% CI = 41.5-55.2%), 48-49 correlated to a 5-year survival of 72.1% (95% CI = 65.6-78.6%), and 50-52 correlated to a 5-year survival of 84.7% (95% CI = 79.6-89.8%). The bootstrap method confirmed the reliability of the score. Prognostic factors significantly associated with survival on both UV and MV analyses were used to construct a valid scoring system that can be used to predict survival of NSCLC patients. Optimally, this score could be used when counseling patients, and designing future trials.
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, 5881 E. Mayo Blvd, Phoenix, Arizona, 85054.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 First St S.W., Rochester, Minnesota, 55905.
authors.forename: Angelina D
authors.initials: AD
authors.lastname: Tan
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 First St S.W., Rochester, Minnesota, 55905.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Wampfler
authors.affiliation: Division of Medical Oncology, Mayo Clinic, 13400 E. Shea Blvd., Scottsdale, Arizona, 85259.
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Ross
authors.affiliation: Epidemiology-Cancer Research, 200 First St S.W., Rochester, Minnesota, 55905.
authors.forename: Ping
authors.initials: P
authors.lastname: Yang
authors.affiliation: Cancer Center Statistics, Mayo Clinic, 200 First St S.W., Rochester, Minnesota, 55905.
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D047368:Tumor Burden
keywords: Age; metastases; nodal spread; non-small cell lung cancer; performance status; prognosis; quality of life; scoring system; smoking; tumor size