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Prognostic factors in patients with stage IV non-small cell lung cancer
引用本文:Meili Ma,Jie Shen,Liyan Jiang,Baohui Han,Hao Bai,Hao Ji,Yizuo Zhao,Bo Jin,Yongfeng Yu,Jun Pei,Wei Zhang Department of Respiration,Shanghai Chest Hospital,Shanghai Jiao Tong University Medical College,Shanghai 200030,China. Prognostic factors in patients with stage IV non-small cell lung cancer[J]. 中德临床肿瘤学杂志, 2006, 5(5): 319-323. DOI: 10.1007/s10330-006-0520-z
作者姓名:Meili Ma  Jie Shen  Liyan Jiang  Baohui Han  Hao Bai  Hao Ji  Yizuo Zhao  Bo Jin  Yongfeng Yu  Jun Pei  Wei Zhang Department of Respiration  Shanghai Chest Hospital  Shanghai Jiao Tong University Medical College  Shanghai 200030  China
作者单位:Meili Ma,Jie Shen,Liyan Jiang,Baohui Han,Hao Bai,Hao Ji,Yizuo Zhao,Bo Jin,Yongfeng Yu,Jun Pei,Wei Zhang Department of Respiration,Shanghai Chest Hospital,Shanghai Jiao Tong University Medical College,Shanghai 200030,China
摘    要:Lung cancer is the leading cause of cancer deaths among both men and women over the world. In 2002, lung can- cer accounted for more deaths than breast cancer, prostate cancer, and colon cancer combined[1]. Non-small cell lung cancer (NSCLC) represents 75%–85% of all lung cancers. Lung cancer is hard to discovered until it’s at an advanced stage and the outlook for recovery is poor. Approximately two-thirds of NSCLC patients have advanced-stage at di- agnosis. Stage IV NSCLC denotes …

收稿时间:2006-08-30
修稿时间:2006-09-26

Prognostic factors in patients with stage IV non-small cell lung cancer
Meili Ma,Jie Shen,Liyan Jiang,Baohui Han,Hao Bai,Hao Ji,Yizuo Zhao,Bo Jin,Yongfeng Yu,Jun Pei,Wei Zhang. Prognostic factors in patients with stage IV non-small cell lung cancer[J]. The Chinese-German Journal of Clinical Oncology, 2006, 5(5): 319-323. DOI: 10.1007/s10330-006-0520-z
Authors:Meili Ma  Jie Shen  Liyan Jiang  Baohui Han  Hao Bai  Hao Ji  Yizuo Zhao  Bo Jin  Yongfeng Yu  Jun Pei  Wei Zhang
Affiliation:(1) Department of Respiration, Shanghai Chest Hospital, Shanghai Jiao Tong University Medical College, Shanghai, 200030, China
Abstract:Objective: To investigate the prognostic factors for stage IV non-small cell lung cancer (NSCLC) with distant metas- tasis and establish a reliable model of clinical prognostic index. Methods: From January 1990 to April 2005, 313 primary NSCLC patients with metastasis, who had been treated in Shanghai Chest Hospital, were reviewed. Survival time was estimated accord- ing to the Kaplan-Meier method. Cox proportional hazard regression model was used for multivariate analysis. Results: Among the 313 cases of non-small cell lung cancer (NSCLC) at stage IV, there were 218 and 95 patients with metastasis to single and different organs, respectively. The overall median survival time for all 313 cases of NSCLC patients was 10.8 (9.00, 12.30) months and the overall 1-, 2-, 3-, 4- and 5-year survival rate was 45%, 18%, 12%, 4% and 0%. There were 63, 174, 127, 36, 18, 11 and 5 patients with metastasis to brain (20.13%), bone (55.59%), lung (40.58%), liver (11.50%), adrenal gland (5.75%), subcutaneous (3.51%) and others, respectively. The survival time was shortest in subcutaneous metastasis (4.6 months), and liver 7.0 months, brain 8.0 months, adrenal gland 8.6 months, bone 10.6 months, lung 11.8 months. Kaplan-Meier estimation showed that patients anatomic typing, KPS, numbers of organ with metastasis, appetite, liver, adrenal gland and subcutane- ous metastasis, body weight loss, smoking, index of smoking, chemotherapy, cycles of chemotherapy were the predictors of survival. Multivariate analysis showed survival statistically significant correlation with anatomic typing, KPS, appetite, liver and subcutaneous metastasis, body weight loss, cycles of chemotherapy. The relative risk (RR) was 1.51, 1.97, 1.55, 1.67, 2.56, and 2.56 respectively. Conclusion: Survival time decreases distinctly in patients who had distant metastasis to more than two different organs (P<0.01). Bone is the commonest organ for distant metastasis in lung cancer. The prognosis is poor when lung cancer appears subcutaneous metastasis and liver metastasis. Independent prognostic factors in patient with stage IV non-small cell lung cancer were liver and subcutaneous metastasis, anatomic typing, KPS, appetite, body weight loss, cycles of chemotherapy.
Keywords:non-small cell lung cancer  prognosis  metastasis  multivariate analysis
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