Park Myoung-Rin, Park Yeon-Hee, Choi Jae-Woo, Park Dong-Il, Chung Chae-Uk, Moon Jae-Young, Park Hee-Sun, Jung Sung-Soo, Kim Ju-Ock, Kim Sun-Young, Lee Jeong-Eun
Department of Public Health Administration, The Province of Chungcheongnam-do, Hongseong, Korea.
Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
Tuberc Respir Dis (Seoul). 2014 May;76(5):218-25. doi: 10.4046/trd.2014.76.5.218. Epub 2014 May 29.
Small cell lung cancer (SCLC) is an extremely aggressive tumor with a poor clinical course. Although many efforts have been made to improve patients' survival rates, patients who survive longer than 2 years after chemotherapy are still very rare. We examined the baseline characteristics of patients with long-term survival rates in order to identify the prognostic factors for overall survivals.
A total of 242 patients with cytologically or histologically diagnosed SCLC were enrolled into this study. The patients were categorized into long- and short-term survival groups by using a survival cut-off of 2 years after diagnosis. Cox's analyses were performed to identify the independent factors.
The mean patient age was 65.66 years, and 85.5% were males; among the patients, 61 of them (25.2%) survived longer than 2 years. In the multivariate analyses, CRP (hazard ratio [HR], 2.75; 95% confidence interval [CI], 1.25-6.06; p=0.012), TNM staging (HR, 3.29; 95% CI, 1.59-6.80; p=0.001), and progression-free survival (PFS) (HR, 11.14; 95% CI, 2.98-41.73; p<0.001) were independent prognostic markers for poor survival rates.
In addition to other well-known prognostic factors, this study discovered relationships between the long-term survival rates and serum CRP levels, TNM staging, and PFS. In situations with unfavorable conditions, the PFS would be particularly helpful for managing SCLC patients.
小细胞肺癌(SCLC)是一种极具侵袭性的肿瘤,临床病程不佳。尽管已经做出了许多努力来提高患者的生存率,但化疗后存活超过2年的患者仍然非常罕见。我们研究了长期生存率患者的基线特征,以确定总生存的预后因素。
本研究共纳入242例经细胞学或组织学诊断为SCLC的患者。通过使用诊断后2年的生存截止值将患者分为长期和短期生存组。进行Cox分析以确定独立因素。
患者的平均年龄为65.66岁,85.5%为男性;其中61例(25.2%)存活超过2年。在多变量分析中,CRP(风险比[HR],2.75;95%置信区间[CI],1.25 - 6.06;p = 0.012)、TNM分期(HR,3.29;95% CI,1.59 - 6.80;p = 0.001)和无进展生存期(PFS)(HR,11.14;95% CI,2.98 - 41.73;p < 0.001)是生存率差的独立预后标志物。
除其他众所周知的预后因素外,本研究发现了长期生存率与血清CRP水平、TNM分期和PFS之间的关系。在条件不利的情况下,PFS对管理SCLC患者特别有帮助。