PROGNOSTIC FACTORS OF SMALL-CELL LUNG-CANCER IN OKAYAMA LUNG-CANCER STUDY-GROUP TRIALS

In order to elucidate factors influencing the prognosis of small-cell lung cancer (SCLC), we reviewed the records of 253 patients with SCLC and evaluated 20 pretreatment prognostic factors by univariate analysi s and Cox's multiple regression analysis. Recursive partitioning and a malgamation (RPA) was employed to identify subgroups with similar surv ival rates. Cox's multiple regression analysis identified five signifi cant factors: extent of disease, number of metastatic sites, serum alb umin, serum lactate dehydrogenase, and presence of weight loss. Among these, extent of disease was the most influential factor. RPA analysis revealed three subgroups predicting significantly different prognoses . The median survival time and 3-year survival rate were 18.4 months a nd 20.6%, respectively for the good-risk group (limited disease withou t weight loss), 13.5 months and 9.1%, respectively for the intermediat e-risk group (limited disease with weight loss or extensive disease wi th less than two metastatic sites), and 9.2 months and 0%, respectivel y for the poor-risk group (extensive disease with two or more metastat ic sites). These results will be useful for development of new staging system or subsequent stratification for randomized trials.