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Pretreatment prognostic factors for survival in non-small-cell lung cancer: A multivariate analysis of 229 patients

Pretreatment prognostic factors for survival in non-small-cell lung cancer: A multivariate analysis of 229 patients

Onkologie 21(3): 204-210

Background: In order to identify the clinical and biochemical important prognostic factors in patients with inoperable non-small-cell lung cancer (NSCLC) receiving chemotherapy or radiochemotherapy, univariate and multivariate regression analyses were performed. Furthermore, we formulated a score for survival that allowed to divide patients into three prognostic groups. Material and Methods: 229 previously untreated patients who had received chemotherapy or combined radiochemotherapy at the Thoraxklinik Heidelberg-Rohrbach between January 1987 and December 1990 were eligible for the analysis. We prospectively evaluated data on 30 pretreatment factors (7 clinical and 23 laboratory variables) and analyzed them by univariate and multivariate methods. Results: The estimated overall median survival time was 161 days. The univariate analyses revealed that 20 parameters were statistically significant for survival. Cox's multivariate regression analysis indicated that female sex (p = 0.012), a sodium level > 137.5 mmol/l (p < 0.001) and a low stage of disease (TNM stages I, II and IIIA) (p < 0.001) contributed independently to survival. Based on these three independent predictive factors, a prognostic factor risk index was created for each patient to divide the patients into three prognostic groups (good, average, poor). The median survival time within these groups was 409 days vs. 160 days vs. 91 days (p < 0.001). Conclusions: Our findings confirm the important role of well-known independent prognostic factors for survival in NSCLC patients, such as TNM and sex. For sodium there are no comparable analyses at present, and therefore further investigation of this factor is needed. The proposed prognostic index appears to be a feasible tool to develop new treatment strategies in NSCLC.

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Accession: 009238833

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DOI: 10.1159/000026816

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