Pretreatment clinical prognostic factors in patients with stage IV non-small cell lung cancer (NSCLC) treated with chemotherapy

Abstract

Purpose: We investigated the influence of potential pre-treatment clinical prognostic factors in stage IV non-small cell lung cancer (NSCLC).

Methods and patients: A total of 285 patients were enrolled in two consecutive prospective randomised studies which compared (study 1) carboplatin and prolonged oral etoposide (group 1; n=58) with the same etoposide alone (group 2; n=59), and (study 2) carboplatin and prolonged oral etoposide (group 1; n=84) with the same carboplatin and high-dose intravenous etoposide (group 2; n=84).

Results: The median survival time for all 285 patients was 7 months, while 1- and 2-year survival rates were 29% and 8%, respectively. Age did not impact on outcome ( P=0.21), while female patients did significantly better than male patients ( P<0.0001). Patients with KPS 80-100 did significantly better than those with KPS 50-70 ( P<0.0001), as did patients with less pronounced weight loss ( P<0.0001) and those with only one metastatic site when compared to those having at least two metastatic sites ( P<0.0001). When evaluated regarding the metastatic site, only subcutaneous metastatic site did not influence survival. This was confirmed within univariate analyses, but when multivariate analyses were done gender, KPS, weight loss, number of metastatic sites, presence of liver metastases and presence of brain metastases independently influenced survival, while age and other metastatic locations did not.

Conclusion: In this analysis, gender, KPS, weight loss, number of metastatic sites, presence of liver metastases and presence of brain metastases independently influenced survival in patients with stage IV NSCLC treated with CHT.

Fig. 1.

Overall survival (all patients)

Fig. 2.

Survival according to gender. Females (broken lines) and males (unbroken lines)

Fig. 3.

Survival according to age. ≥60 years (broken lines) and <60 years (unbroken lines)

Fig. 4.

Survival according to KPS. 80–100 (broken lines) and 50–70 (unbroken lines)

Fig. 5.

Survival according to pretreatment weight loss. =5% (broken lines) and >5% (unbroken lines)

Fig. 6.

Survival according to the number of metastatic sites. =1 (broken lines) and ≥2 (unbroken lines)

Fig. 7

. Survival according to the presence of liver metastasis. No presence (broken lines) and presence (unbroken lines)

Fig. 8.

Survival according to the presence of brain metastasis. No presence (broken lines) and presence (unbroken lines)

Fig. 9.

Survival according to presence of bone metastasis. No presence (broken lines) and presence (unbroken lines)

Fig. 10.

Survival according to presence of lung metastasis. No presence (unbroken lines) and presence (broken lines)

Fig. 11.

Survival according to presence of subcutaneous metastasis. No presence (broken lines) and presence (unbroken lines)

Fig. 12.

Survival according to presence of bone marrow metastasis. No presence (broken lines) and presence (unbroken lines)

Fig. 13.

Survival according to presence of other metastasis. No presence (broken lines) and presence (unbroken lines)