Prognostic factors and prognostic staging system for small cell lung cancer.

Abstract:

:This study was performed to assess the prognostic factors and the predictors of long-term (3-year) survival in patients with small cell carcinoma of the lung, accrued in one randomized trial, and to define patient subgroups showing significantly different survivals using recursive partitioning and amalgamation analysis. A total of 300 patients with small cell carcinoma of the lung were entered into a randomized study comparing cyclophosphamide, adriamycin and vincristine (CAV), cisplatin and etoposide (PE) and alternating treatments of CAV and PE. Of these, 286 patients were analysed for the present study of prognostic factors. Multivariate analysis showed that poor performance status (2-3) (P = 0.0001), extensive disease (P = 0.0015) and abnormally elevated serum lactate dehydrogenase (P = 0.0001) and alkaline phosphatase (P = 0.0013) were independently adverse pretreatment prognostic factors. Of limited disease patients, performance status (P = 0.029) and white blood cell count (P = 0.044) had a significant influence on the probability of 3-year disease-free survival. Using recursive partitioning and amalgamation analysis, three classes of similar prognosis were identified: the most favorable class was defined by knowledge of lactate dehydrogenase (normal), performance status (0-1) and serum sodium levels (normal) with median survival time of 16.0 months, and the class with the poorest prognosis was defined by knowledge of lactate dehydrogenase (elevated) and performance status (2-3) (median survival time 6.6 months). The intermediate class had a median survival time of 9.4 months. In conclusion, this subclassification system will be used for the design, implementation and interpretation of clinical studies as well as decision-making in individual patients.

journal_name

Jpn J Clin Oncol

authors

Kawahara M,Fukuoka M,Saijo N,Nishiwaki Y,Ikegami H,Tamura T,Shimoyama M,Suemasu K,Furuse K

doi

10.1093/jjco/27.3.158

subject

Has Abstract

pub_date

1997-06-01 00:00:00

pages

158-65

issue

3

eissn

0368-2811

issn

1465-3621

journal_volume

27

pub_type

临床试验,杂志文章,随机对照试验
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    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

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