Advanced Non-Small Cell Lung Cancer: Retrospective Study of PrognosticFactors

Abstract

Objective: The objective of the study is to investigate and improve our understanding of the impact of several potential prognostic factors on overall survival (OS) in patients with advanced non-small cell lung cancer (NSCLC). Methods: Records of patients with advanced NSCLC (stage IIIB, IV) received first-line chemotherapy were reviewed. Age, gender, Eastern Cooperative Oncology Group performance status (ECOGPS), stage, histologic type, smoking status, leucocytic count, type of chemotherapy, albumin and hemoglobin level were evaluated for their prognostic significance in multivariate analysis. Results: A total of 140 patients with advanced NSCLC treated with first-line chemotherapy were identified. The median age was 54 (range from 35-83) years. The majority of patients were male (72%), had stage IIIB (67%) and were in PS 0or1 (75.7%). Forty-six percent had adenocarcinoma. Most patients were smokers (85%) and received platinum-based chemotherapy (78.6%).1-year OS was 39.3% with median survival time of 10 months (95% CI: 7.95-12).ECOGPS of 2(P=0.04), squamous histology (P=0.03), elevated leucocytic count (P=0.02),low hemoglobin level(P=0.02), smoking (P=0.03), low albumin level (P=0.05) and stage IV (P=0.01)were found to be independent prognostic factors for poor survival in multivariate analysis. While age (P=0.23), sex (P=1) and type of chemotherapy whether platinum-based or not (P=0.8) were insignificant factors for survival. Conclusion: From this study, we concluded that prognostic factors as smoking, ECOG PS of 2, squamous histology, stage IV, high leucocytic count, low hemoglobin level, low albumin level are found to have a significant impact on the survival while, gender, age, and type of chemotherapy are not. However, these results and additional information regarding prognostic factors in patients with advanced NSCLC in prospective studies should be validated.