Ando M, Ando Y, Sugiura S, Minami H, Saka H, Sakai S, Shimokata K, Hasegawa Y
Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital.
Jpn J Cancer Res. 1999 Feb;90(2):249-53. doi: 10.1111/j.1349-7006.1999.tb00740.x.
Prognostic factors which can forecast short-term survival in patients with stage IV non-small cell lung cancer have not been well evaluated. Characteristics of such factors may be different from those for overall survival, and would be an important eligibility criterion for clinical trials of chemotherapy. We retrospectively analyzed the data of 158 patients with stage IV non-small cell lung cancer whose performance status was 0, 1 or 2. Univariate and multivariate logistic regression models revealed demographic variables which significantly correlated with the survival at 8 or 12 weeks. The univariate model showed the following significant variables: T factor, N factor, number of organs with metastases, grade of performance status, weight loss within 6 months, evidence of metastasis either at bone or lymph node, and lactate dehydrogenase level. The subsequent multivariate model demonstrated that both grade of performance status under 2 and number of metastasized organs less than 3 are important factors for 8- or 12-week survival. The survival rate in patients meeting the two criteria (grade of performance status under 2 and number of metastasized organs less than 3) and in those meeting only one of them was 93% versus 80% at 8 weeks (P = 0.030) and 88% versus 62% at 12 weeks (P < 0.001), respectively. Grade of performance status and number of organs with metastases appear to be important prognostic factors for short-term survival in patients with stage IV non-small cell lung cancer.
能够预测IV期非小细胞肺癌患者短期生存情况的预后因素尚未得到充分评估。这类因素的特征可能与总体生存情况的因素不同，并且会是化疗临床试验的一项重要入选标准。我们回顾性分析了158例体能状态为0、1或2的IV期非小细胞肺癌患者的数据。单因素和多因素逻辑回归模型揭示了与8周或12周生存率显著相关的人口统计学变量。单因素模型显示了以下显著变量：T因子、N因子、转移器官数量、体能状态分级、6个月内体重减轻情况、骨或淋巴结转移证据以及乳酸脱氢酶水平。随后的多因素模型表明，体能状态分级低于2以及转移器官数量少于3是8周或12周生存的重要因素。符合这两个标准（体能状态分级低于2且转移器官数量少于3）的患者与仅符合其中一项标准的患者在8周时的生存率分别为93%和80%（P = 0.030），在12周时分别为88%和62%（P < 0.001）。体能状态分级和转移器官数量似乎是IV期非小细胞肺癌患者短期生存的重要预后因素。
