title: Prognostic Factor Analysis in Patients With Small-Cell Lung Cancer Treated With Third-Line Chemotherapy.
abstract: There is little information on the clinical outcome of patients with small-cell lung cancer (SCLC) treated with third-line chemotherapy. The purpose of this study was to clarify the prognostic factors of SCLC patients receiving third-line chemotherapy.
  
  
  
  Between November 2001 and October 2011, 202 of 648 consecutive SCLC patients at the National Cancer Center Hospital East received third-line chemotherapy. Multivariate Cox regression analysis was performed to identify the prognostic factors for overall survival after third-line chemotherapy.
  
  
  
  The demographics of the 202 patients were as follows: median age 66 years, 83% male, and Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, 2, and 3 values of 22, 122, 49, and 9, respectively. Median time to treatment failure after second-line chemotherapy (TTF2) was 4.5 months (TTF2 ≥ 5/< 5 months, 82/120). The median overall survival after third-line chemotherapy was 5.1 months. Multivariate Cox regression analysis showed that PS 0-1 (hazard ratio, 0.38; 95% confidence interval, 0.27-0.54; P < .001) and TTF2 ≥ 5 months (hazard ratio, 0.57; 95% confidence interval, 0.41-0.79; P < .001) were independent prognostic factors. TTF2 threshold of 5 months was determined on the basis of concordance probability adjusted by PS.
  
  
  
  PS 0-1 and TTF2 ≥ 5 months were associated with a favorable prognosis among SCLC patients receiving third-line chemotherapy. These 2 factors might be helpful for the selection of candidates for third-line chemotherapy and for patient stratification when conducting future clinical trials in the third-line setting.
authors.affiliation: Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Saruwatari
authors.affiliation: Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan. Electronic address: sumemura@east.ncc.go.jp.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Umemura
authors.affiliation: Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Kashiwa, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Nomura
authors.affiliation: Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kirita
authors.affiliation: Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Yoh
authors.affiliation: Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Niho
authors.affiliation: Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Ohmatsu
authors.affiliation: Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Ohe
authors.affiliation: Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Goto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005163:Factor Analysis, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000473:pathology; D015996:Survival Rate
keywords: Performance status; Prognostic factor; Small-cell lung cancer; Third-line; Time to treatment failure