Journal of Cancer Research and Treatment
ISSN (Print): 2374-1996 ISSN (Online): 2374-2003 Website: https://www.sciepub.com/journal/jcrt Editor-in-chief: Jean Rommelaere
Open Access
Journal Browser
Go
Journal of Cancer Research and Treatment. 2017, 5(2), 55-61
DOI: 10.12691/jcrt-5-2-3
Open AccessArticle

Prognostic Factors in Advanced Non-Small Cell Lung Cancer and Their Relation to Clinical Outcomes

Mohamed-Alaa-Eldeen Hassan Mohamed1, , Samir Shehata Mohamed1, Hoda Hassan Essa1 and Hebat-Allaa mahmoud Bakri1

1Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Egypt

Pub. Date: June 01, 2017

Cite this paper:
Mohamed-Alaa-Eldeen Hassan Mohamed, Samir Shehata Mohamed, Hoda Hassan Essa and Hebat-Allaa mahmoud Bakri. Prognostic Factors in Advanced Non-Small Cell Lung Cancer and Their Relation to Clinical Outcomes. Journal of Cancer Research and Treatment. 2017; 5(2):55-61. doi: 10.12691/jcrt-5-2-3

Abstract

Background: Lung cancer is the main cause of cancer deaths worldwide. It is important to identify the prognostic factors of this disease which leads to low survival times despite the advancing treatment modalities. Aim: To investigate the role of clincopathological parameters and treatment modality as a prognostic factors affecting survival of patients with advanced non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed the clinical records of patients with inoperable stage III/IV NSCLC, who were treated at the department of Clinical Oncology, Assiut University Hospital between 2009 and 2014. The association between the demographic and clinical characteristics and survival of these patients was analyzed. Results: A total of 69 patients (32 stage III& 39 stage IV) were identified and included in this study. Sex (males vs. females, p=0.04), Eastern cooperative Oncology group performance status (0 vs. 1 vs. 2, p=0.001), smoking habit (never vs. current vs. former, p=0.001), stage (IIIA vs. IIIB vs. IV, p=0.008) and the initial treatment (no vs. chemotherapy vs. concurrent chemoradiotherapy, p=0.001) were found to be factors affecting survival in univariate analyses. Sex and histological subtype did not affect survival. Performance status, stage and initial treatment were determined as the independent prognostic factors affecting survival in multivariate analyses. Conclusion: Performance status, stage and initial treatment with concurrent chemoradiotherapy in eligible patients were prognostic factors affecting overall survival of patients with advanced NSCLC.

Keywords:
non-small cell lung cancer prognostic factors survival

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  American Cancer Society: Cancer Facts and Figures 2016. Atlanta, Ga: American Cancer Society, 2016. .Exit Disclaimer Last accessed July 11, 2016.
 
[2]  Siegel RL, Miller KD, Jemal A. Cancer Statics, 2015. CA Cancer J Clin, 65, 5-29.
 
[3]  Ries L, Eisner M, Kosary C, et al., eds.: Cancer Statistics Review, 1975-2002. Bethesda, Md: National Cancer Institute, 2005. Last accessed July 11, 2016.
 
[4]  Coleman MP, Gatta G, Verdecchia A, et al.: EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century. Ann Oncol. 2003, 14:128-149.
 
[5]  Rodrigues G, Choy H, Bradley J, et al.: Definitive radiation therapy in locally advanced nonsmall cell lung cancer: executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based clinical practice guideline. Pract Radiat Oncol. 2015, 5:141-148.
 
[6]  León-Atance P, Moreno-Mata N, González-Aragoneses F, et al. Multicenter analysis of survival and prognostic factors in pathologic stage I non-small-cell lung cancer according to the new 2009 TNM classification. Arch Bronconeumol. 2011; 47(9): 441-6.
 
[7]  Brundage MD, Davies D, Mackillop WJ. Prognostic factors in non-small cell lung cancer: a decade of progress. Chest. 2002; 122(3): 1037-57.
 
[8]  Auperin A, Le Pechoux C, Rolland E, et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J C Oncol 2010, 28, 2181-90.
 
[9]  Van Baardwijk A, Wanders S, Boersma L, et al. Mature results of an individualized radiation dose prescription study based on normal tissue constraints in stages I to III non-small-cell lung cancer. J Clin Oncol 2010, 28, 1380-6.
 
[10]  Edge SB, Compton CC. The American Joint Committee on Cancer Staging Manual and the Future of TNM. Ann Sur Oncol 2010; 17: 1471-1474.
 
[11]  Greene FI. American Joint Committee on Cancer, American Cancer Society. AJCC Cancer Staging manual. 6th ed. Philadelphia; Springer 2002.
 
[12]  Hirsch FR, Spreafico A, Novello S,et al. The Prognostic and Predictive Role of Histology in Advanced Non-small Cell Lung Cancer A Literature Review. Journal of Thoracic Oncology 2008, Volume 3, Number 12, 1468-81.
 
[13]  Kawaguchi T, Takada M, Kubo A, et al. Performance status and smoking status are independent favorable prognostic factors for survival in non-small cell lung cancer: a comprehensive analysis of 26,957 patients with NSCLC. J Thorac Oncol. 2010; 5(5): 620-30.
 
[14]  Rebelo M, Parkin DM, Forman D, Bray, F. GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide. IARC CancerBase [serial on the Internet]. 2013 [cited 2015 Jul 1]; 11. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr.
 
[15]  Souza MC, Cruz OG, Vasconcelos AG. Factors associated with disease-specific survival of patients with non-small cell lung cancer. J Bras Pneumol. 2016; 42(5): 317-325.
 
[16]  Urvay SE, Yucel B, Erdis E, Turan N. Prognostic Factors in Stage III Non-Small-Cell Lung Cancer Patients. Asian Pacific Journal of Cancer Prevention 2016, Vol 17.
 
[17]  Kumar N, Tan KA, Tan JH, et al. The Influence of Histologic Subtype in Predicting Survival of Lung Cancer Patients with Spinal Metastases. J Clin Spine Surg. 2016; 21. [Epub a head of print].
 
[18]  Ben Amar J, Ben Safta B, Zaibi H, et al. Prognostic factors of advanced stage non-small-cell lung cancer. J Tunis Med. 2016 May; 94(5): 360-367.
 
[19]  Shapiro JA, Jacobs EJ, Thun M. Cigar smoking in men and risk of death from tobacco-related cancers. J Natl Cancer Inst. 2000, 16; 92(4): 333-7.
 
[20]  Araujo L, Baldotto C, Zukin M, et al. Survival and prognostic factors in patients with non-small cell lung cancer treated in private health care. Rev Bras Epidemiol. 2014; 17(4): 1001-1014.
 
[21]  Zhang Y, Elgizouli M, Schöttker B. Smoking-associated DNA methylation markers predict lung cancer incidence. Clin Epigenetics. 2016 Nov 25;8:127. eCollection 2016.
 
[22]  Wahbah M, Boroumand N, Castro C, et al. Changing trends in the distribution of the histologic types of lung cancer: a review of 4,439 cases. Ann Diagn Pathol 2007, 11, 89-96.
 
[23]  Kelly K, Chansky K, Mack PC, et al. Chemotherapy Outcomes by Histologic Subtypes of Non-Small cell Lung Cancer: Analysis of the Southwest Oncology Group Database for Antimicrotubule-Platinum Therapy. Clin Lung Cancer. 2013 November; 14(6): 627-635.
 
[24]  Abbasi S, Badheeb A. Prognostic Factors in Advanced Non-Small-Cell Lung Cancer Patients: Patient Characteristics and Type of Chemotherapy. Lung Cancer Int. 2011; 2011: 152125.
 
[25]  Kanzaki H, Kataoka M, Nishikawa A, et al. Impact of early tumor reduction on outcome differs by histological subtype in stage III non-small-cell lung cancer treated with definitive radiotherapy. Int J Clin Oncol. 2016 Oct; 21(5): 853-861. Epub 2016 Apr 28.
 
[26]  Liu H, Marc Kerba, Gerald Lim, et al. Factors Associated With the Use of Radiation Therapy in Patients With Stage III Non-small Cell Lung Cancer in Alberta, Canada: A Population-based Study. Cureus 2016, 8(10): e851.
 
[27]  Blanchon F, Grivaux M, Asselain B, et al. 4year mortality in patients with non-small-cell lung cancer: development and validation of a prognostic index. Lancet Oncol. 2006 Oct; 7(10): 829-36.
 
[28]  O’Rourke N, Roque I Fıguls M, Farre Bernado N, et al. Concurrent chemoradiotherapy in non-small cell lung cancer. Cochrane Database Syst Rev 2010, 16, CD002140.
 
[29]  Curran WJ-Jr, Paulus R, Langer CJ, et al. Sequential vs. Concurrent Chemoradiation for stage III non-small cell lung cancer: randomised phase III trial RTOG 9410. J Natl Cancer Inst 2011, 103, 1452-60.
 
[30]  Sause W, Kolesar P, Taylor S IV, et al. Final results of phase III trial in regionally advanced unresectable non-small cell lung cancer: radiation therapy oncology group, eastern cooperative oncology group and southwest oncology group. Chest 2000, 117, 358-64.
 
[31]  Tsujıno K, Kurata T, Yamamoto S, et al. Is consolidation chemotherapy after concurrent chemo-radiotherapy beneficial for patients with locally advanced non-small-cell lung cancer? A pooled analyses of the literature. J Thorac Oncol 2013, 8, 1181-9.
 
[32]  Jiang J, Liang X, Zhou X, Huang R Non-platinum doublets were as effective as platinum-based doublets for chemotherapy-naïve advancednon-small-cell lung cancer in the era of third-generation agents. J Cancer Res Clin Oncol. 2013 Jan; 139(1):25-38.
 
[33]  Lin JH, Lin D, Xu L, et al. The association between clinical prognostic factors and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) efficacy in advanced non-small-cell lung cancer patients: a retrospective assessment of 94 cases with EGFR mutation. Oncotarget. 2016 Dec 3.
 
[34]  Kong M, Hong SE. Comparison of survival rates between 3D conformal radiotherapy and intensity-modulated radiotherapy in patients with stage III non-small cell lung cancer. Onco Targets Ther. 2016 Nov 24; 9: 7227-7234. eCollection 2016.
 
[35]  He J, Huang Y, Chen Y, et al. Feasibility and efficacy of helical intensity-modulated radiotherapy for stage III non-small cell lung cancer in comparison with conventionally fractionated 3D-CRT. J Thorac Dis. 2016 May; 8(5): 862-71.
 
[36]  Higgins KA, O'Connell K, Liu Y, et al. National Cancer Database Analysis of Proton Versus Photon Radiation Therapy in Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys. 2017 Jan 1; 97(1): 128-137.