The prognostic value of the simplified comorbidity score in the treatment of small cell lung carcinoma

Abstract

Introduction: Comorbidity may be an important prognostic factor in the treatment of small cell lung carcinoma (SCLC). This study aimed to investigate the prognostic values of simplified comorbidity score (SCS) in the treatment of patients with SCLC.

Methods: The patients with SCLC admitted to the National Taiwan University Hospital during the period from January 2000 to December 2006 were included. The medical records were reviewed and analyzed. The SCS was used to evaluate comorbidities of the patients. A Cox proportional hazard model was used to calculate the hazard ratio (HR) and 95% confidence intervals (CIs) for age, gender, and factors significantly associated with survival identified in univariate analyses.

Results: A total of 172 patients were included; 56 patients had limited-stage disease and 116 had extensive-stage disease. Patients with an SCS more than 9 had shorter overall survival than those with SCS ≤ 9 both in limited-stage (372 days versus 581 days, p = 0.01) and extensive-stage disease (215 days versus 324 days, p = 0.001). Multivariate analysis indicated that SCS more than 9 was associated with a worse prognosis in patients with limited-stage disease (HR: 2.17, 95% CI: 1.12-4.21) and extensive-stage disease (HR: 1.74, 95% CI: 1.12-2.72), respectively. For patients with extensive-stage disease, SCS more than 9 was associated with poor treatment response (> 9 versus ≤ 9, disease response rate: 60.0% versus 82.4%, p = 0.02).

Conclusions: The SCS may be an independent prognostic factor for patients with SCLC. Large-scale prospective studies may be required to validate the prognostic value of the SCS for SCLC.