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A prognostic model for advanced stage nonsmall cell lung cancer
Author(s) -
Mandrekar Sumithra J.,
Schild Steven E.,
Hillman Shauna L.,
Allen Katie L.,
Marks Randolph S.,
Mailliard James A.,
Krook James E.,
Maksymiuk Andrew W.,
Chansky Kari,
Kelly Karen,
Adjei Alex A.,
Jett James R.
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22049
Subject(s) - medicine , stage (stratigraphy) , univariate analysis , lung cancer , body mass index , oncology , proportional hazards model , white blood cell , cancer , gastroenterology , multivariate analysis , performance status , paleontology , biology
BACKGROUND. A pooled analysis was performed to examine the impact of pretreatment factors on overall survival (OS) and time to progression (TTP) in patients with advanced‐stage nonsmall cell lung cancer (NSCLC) and to construct a prediction equation for OS using pretreatment factors. METHODS. A pooled data set of 1053 patients from 9 North Central Cancer Treatment Group trials was used. Age, gender, Eastern Cooperative Oncology Group performance status (PS), tumor stage (Stage IIIB vs. Stage IV), body mass index (BMI), creatinine level, hemoglobin (Hgb) level, white blood cell (WBC) count, and platelet count were evaluated for their prognostic significance in both univariate and multivariate analyses by using a Cox proportional‐hazards model. RESULTS. Patients who had high WBC counts, low Hgb levels, PS >0, BMI <18.5 kg/m 2 , and TNM Stage IV disease had significantly worse TTP and OS. Patients who had Stage IV disease with a high WBC count had a particularly poor prognosis. An equation to predict the OS of patients with Stage IV NSCLC based on pretreatment PS, BMI, Hgb level, and WBC count was constructed. CONCLUSIONS. In addition to the widely accepted prognostic factors of PS, BMI, and disease stage, both of the readily available laboratory parameters of Hgb level and WBC count were found to be significant prognostic factors for OS and TTP in patients with advanced‐stage NSCLC. The authors' prediction equation can be used to evaluate the benefit of a treatment in Phase II trials by comparing the observed survival of a cohort with its expected survival by using the patients' own prognostic factors in place of comparisons with historic data that may have substantially different baseline patient characteristics. Cancer 2006. © 2006 American Cancer Society.