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. 2019 Oct;8(5):593-604.
doi: 10.21037/tlcr.2019.09.19.

Survival score to characterize prognosis in inoperable stage III NSCLC after chemoradiotherapy

Julian Taugner  1 , Lukas Käsmann  1   2   3 , Chukwuka Eze  1   2 , Maurice Dantes  1   2 , Olarn Roengvoraphoj  1 , Kathrin Gennen  1 , Monika Karin  1 , Oleg Petruknov  1 , Amanda Tufman  2   4 , Claus Belka  1 , Farkhad Manapov  1   2
Affiliations

Survival score to characterize prognosis in inoperable stage III NSCLC after chemoradiotherapy

Julian Taugner et al. Transl Lung Cancer Res. 2019 Oct.

Abstract

Background: Stage III non-small cell lung cancer (NSCLC) represents a heterogeneous disease regarding principal patient- and tumor characteristics. A simple score may aid in personalizing multimodal therapy.

Methods: The data of 99 consecutive patients with performance status ECOG 0-1 treated until the end of 2016 with multimodal approach for inoperable NSCLC (UICC 7th edition stage IIIA/B) were evaluated. Patient- and tumor-related factors were examined for their impact on overall survival. Factors showing a negative association with prognosis were then included in the score. Three subgroups with low, intermediate and high-risk score were defined. The results were then validated in the prospective cohort, which includes 45 patients.

Results: Most Patients were treated with concurrent (78%) or sequential (11%) chemoradiotherapy. 53% received induction chemotherapy. Median survival for the entire cohort was 20.8 (range: 15.3-26.3) months. Age (P=0.020), gender (P=0.007), pack years (P=0.015), tumor-associated atelectasis (P=0.004) and histology (P=0.004) had a significant impact on overall survival and were scored with one point each. Twelve, 59 and 28 patients were defined to have a low (0-1 points), intermediate (2-3 points) and high-risk (4-5 points) score. Median survival, 1-, 2- and 3-year survival rates were not reached, 100%, 83% and 67% in the low, 22.9 months, 80%, 47% and 24% intermediate and 13.7 months, 57%, 25% and 18% high-risk patients, respectively (P<0.001). Median survival was not reached in prospective cohort; analysis has revealed a trend for the 1-year survival rates with 100% for the low, 93% intermediate and 69% high-risk patients (P=0.100).

Conclusions: The score demonstrated remarkable survival differences in inoperable stage III NSCLC patients with good performance status receiving multimodal therapy.

Keywords: Non-small cell lung cancer (NSCLC); multimodal therapy; prognostic factors; survival-score.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Event-free survival (EFS) by (A) age, (B) gender, (C) tobacco consumption, (D) atelectasis, (E) tumor histology, (F) score groups.
Figure 2
Figure 2
Overall survival (OS) by (A) age, (B) gender, (C) tobacco consumption, (D) atelectasis, (E) tumor histology, (F) score groups.
Figure 3
Figure 3
Overall survival in the validation cohort by score groups.
See this image and copyright information in PMC

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