Small Cell Lung Cancer: Analysis of Factors Influencing the Response to Treatment and Survival

Abstract

The aims of this study were to identify prognostic factors in patients (pts) with small cell lung cancer and to identify dominant prognostic factors independent of disease stage, to define prognostic subsets through recursive partitioning and amalgamation (RPA) and to analyze the clinical characteristics of long-term survivors. The prognostic significance of 27 pre-treatment variables was evaluated in 144 pts seen at a single institution. The current study confirmed the superior outcome for pts with limited disease (LD) in terms of response, response duration, time to treatment failure and survival when compared to those with extensive disease (ED). None of the variables independently predicted for response in patients with LD. Response correlated significantly with a good performance status (PS) for pts with ED and for the whole group. A good PS was the most significant predictor for prolonged survival in pts with LD. In ED a longer survival was associated with a normal pre-treatment albumin value, absence of weight loss and female gender. When the whole group was considered, PS and number of metastatic sites were identified as the most influential factors for survival independent of disease stage. RPA analysis defined 3 prognostic subsets based on stage of disease, PS and number of metastatic sites. The best survival rates were seen in pts with LD with a good PS and pts with ED, only one metastatic site and a good PS. 11 % of pts survived > 2 years (18% LD, 6% ED). A complete response to chemotherapy was the most important predictor for long-term survival. Comparison of the data from this study with published results of protocol studies showed similar outcomes.

Prognostic Factors in Small Cell Lung Cancer: A New Prognostic Index in Korean Patients

“…Our report confirmed previous observations that extent of disease and performance status were strong prognostic factors for OS of SCLC patients [1,3,33,38]. Additionally, in agreement with a previous study, elevated CYFRA 21-1 level was associated with a poor outcome in SCLC patients [24].…”

Does Sex Influence the Impact That Smoking, Treatment Interruption and Impaired Pulmonary Function Have on Outcomes in Limited Stage Small Cell Lung Cancer Treatment?

“…The results suggest, firstly, that women tend to do better than men, irrespective of the particular variable under study. This strong positive prognostic association between female sex and survival is supported by the majority of published reports on the impact of sex on a diagnosis of LS-SCLC (11)(12)(13)(14)(15). In our study, we found an overall fivefold absolute difference in survival at five years favouring women over men.…”

“…An incidental finding in these studies, revealed on multivariable analysis, was that despite the negative variables, female sex emerged as a strong positive prognostic factor (8)(9)(10). In itself, this fit with a large number of previous reports demonstrating female sex to be a positive factor in SCLC (11)(12)(13)(14)(15), as compared with a smaller number of reports that show sex has no effect on survival (16,17).…”

Gender, Race, and Survival: A Study in Non–Small-Cell Lung Cancer Brain Metastases Patients Utilizing the Radiation Therapy Oncology Group Recursive Partitioning Analysis Classification

“…To date, there are a large number of publications suggesting that women diagnosed with NSCLC (10)(11)(12)(13)(14) small-cell lung cancer (15)(16)(17)(18)(19)(20)(21) have a better prognosis than men. With specific reference to brain metastases and NSCLC, there are retrospective studies suggesting that female gender may have a positive impact on outcomes (22)(23)(24)(25).…”