Prognostic significance of the baseline serum uric acid level in non-small cell lung cancer patients treated with first-line chemotherapy: a study of the Turkish Descriptive Oncological Researches Group

Abstract

Non-small cell lung cancer (NSCLC) is one of the most common cancers. Most of the patients are inoperable at the time of diagnosis, and the prognosis is poor. Many prognostic factors have been identified in prior studies. However, it is not clear which factor is more useful. In this study, we investigated whether uric acid, the last breakdown product of purine metabolism in humans, has a prognostic significance in advanced NSCLC. A total of 384 NSCLC patients at stage IIIB/IV and who did not meet exclusion criteria were included in this retrospective cross-sectional study. The patients' serum uric acid levels before first-line chemotherapy and demographic (age, gender, smoking), clinical (performance status, weight loss, disease stage, first-line treatment regimen), laboratory (hemoglobin, lactate dehydrogenase), and histologic (histologic type, tumor grade) characteristics were recorded. First, a cut-off value was determined for serum uric acid level. Then, the patients were stratified into four groups (quartiles) based on their serum uric acid levels. Descriptive statistics, univariate and multivariate analyses, and survival analyses were used. Majority of the patients were males, smokers and metastatic at time of diagnosis and had history of weight loss and adenocarcinoma upon pathological examination. The serum uric acid levels of all patients were determined as 4.9±2.9 (range 1.9-11.3). The patients were stratified according to quartiles of serum uric acid concentration with cutoff values defined as <3.08 mg/dL (lowest quartile, Group 1), 3.09-5.91 mg/dL (Group 2), 5.92-7.48 mg/dL (Group 3), and >7.49 mg/dL (highest quartile, Group 4). Among the patients who had serum uric acid levels over 7.49, it was observed that those who also had squamous cell carcinoma had a greater rate of brain metastasis, a shorter time lapse until brain metastasis, and lower overall survival rate. It can be assumed that NSCLC patients who had histologically shown squamous cell carcinoma display brain metastasis and poor prognosis. It can be recommended to repeat this study with larger patient series including immunohistochemical, molecular, and wider laboratory investigations.

Role of increased mean platelet volume (MPV) and decreased MPV/platelet count ratio as poor prognostic factors in lung cancer

“…Squamous cell carcinoma, adenocarcinoma, adenosquamous cell carcinoma, and large-cell carcinoma are histological sub-groups of NSCLC. [3][4][5] Anatomical, clinical, and sociodemographic characteristics conventionally used as prognostic factors include phase, performance status, gender, age, and histological type. 1,2 The prognosis is generally not good for NSCLC with 80% being inoperable at the time of diagnosis and a 5-year overall survival of approximately 5%-10%.…”

“…These histological types are been grouped together because their prognosis characteristics and treatment approaches are nearly similar. [3][4][5] However, the usefulness of any of these factors as an independent prognostic factor is not yet certain. 1 Previous studies have investigated the effect of clinical, histological, biological, chemical, and genetic characteristics on the prognosis of NSCLC patients.…”

“…1,2 The prognosis is generally not good for NSCLC with 80% being inoperable at the time of diagnosis and a 5-year overall survival of approximately 5%-10%. 4,5 More recent studies have also used molecular, genetic, and treatment characteristics as prognostic factors due to their predictive values. [3][4][5] Anatomical, clinical, and sociodemographic characteristics conventionally used as prognostic factors include phase, performance status, gender, age, and histological type.…”

Pretreatment Serum Albumin Level is an Independent Prognostic Factor in Patients with Stage IIIB Non-Small Cell Lung Cancer: A Study of the Turkish Descriptive Oncological Researches Group

“…as patient characteristics including weight loss, smoking habits, comorbidities, and ethnicity and tumor features including histological degree, number of metastatic sites, vascular or local invasion, malign pleural effusion, and localization of the primary tumor may be potential prognostic factors in NSCLC.3-5 It is still unknown, however, which one is more useful and independent factor in the prognosis of the disease (Berghmans et al, 2011;Tanriverdi et al, 2014). Currently, certain molecular markers, genetic features, and treatment modalities have been suggested to be possible prognostic factors and have predictive values (Berghmans et al, 2008;Seculier et al, 2008).…”

“…Currently, certain molecular markers, genetic features, and treatment modalities have been suggested to be possible prognostic factors and have predictive values (Berghmans et al, 2008;Seculier et al, 2008). In recent years, a number of biomarkers having a prognostic impact have been widely studied in NSCLC (Tanriverdi et al, 2014).…”