A Clinical Prognostic Score to Predict Survival of Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) Patients Receiving First-Line Chemotherapy: A Retrospective Analysis
Jing Gong, Ling Xu, Zhi Li, Xuejun Hu, Jing Liu, Yuee Teng, Bo Jin, Mingfang Zhao, Jing Shi, Tianshu Guo, Xiaonan Shi, Yu Cheng, Yunpeng Liu, Xiujuan Qu
Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
Med Sci Monit 2018; 24:8264-8271
Although several complicated models have been built to evaluate the prognosis of NSCLC patients receiving chemotherapy, simple economic models are still needed to give a preliminary survival assessment of these patients.
MATERIAL AND METHODS: This study retrospectively assessed the clinical and biological parameters of 223 patients with advanced NSCLC. Univariate and multivariate analyses of overall survival (OS) and progression-free survival (PFS) for the parameters and the prognostic score were assessed.
RESULTS: Performance status (PS) score=1, smoking history, fibrinogenemia, thrombocytosis, increased lactate dehydrogenase (LDH) level, and anemia were independent predictors of poor prognosis in the univariate analysis of OS and were assessed in multivariate analysis. There was a significant difference in PS=1 (HR=2.134, p<0.0001), increased LDH level (HR=1.508, p=0.014), thrombocytosis (HR=1.547, p=0.012), and smoking history (HR=1.491, p=0.008), based on which the patients were classified into 3 risk groups: low risk (0–1 points), moderate risk (2 points), and high risk (3–5 points). At p values of <0.0001, the median OS was 565, 340, and 273 days and the median progression-free survival was 250, 209, and 135 days, respectively in these 3 risk groups.
CONCLUSIONS: We established a new prognostic score model using PS, LDH level, PLT count, and smoking history to predict the survival of patients receiving first-line chemotherapy for advanced NSCLC, which might be useful in clinical practice.
Keywords: Lung Neoplasms, Overall, Prognosis, Survival