PRETREATMENT PROGNOSTIC FACTORS FOR SURVIVAL IN NON-SMALL-CELL LUNG-CANCER - A MULTIVARIATE-ANALYSIS OF 229 PATIENTS

Background: In order to identify the clinical and biochemical importan t prognostic factors in patients with inoperable non-small-cell lung c ancer (NSCLC) receiving chemotherapy or radiochemotherapy, univariate and multivariate regression analyses were performed. Furthermore, we f ormulated a score for survival that allowed to divide patients into th ree prognostic groups Material and Methods: 229 previously untreated p atients who had received chemotherapy or combined radiochemotherapy at the Thorax-klinik Heidelberg-Rohrbach between January 1987 and Decemb er 1990 were eligible for the analysis. We prospectively evaluated dat a on 30 pretreatment factors (7 clinical and 23 laboratory variables) and analyzed them by univariate and multivariate methods Results: The estimated overall median survival time was 161 days. The univariate an alyses revealed that 20 parameters were statistically significant for survival. Cox's multivariate regression analysis indicated that female sex (p = 0.012), a sodium level > 137.5 mmol/l (p < 0.001) and a low stage of disease (TNM stages I, II and IIIA) (p < 0.001) contributed i ndependently to survival. Based on these three independent predictive factors, a prognostic factor risk index was created for each patient t o divide the patients into three prognostic groups (good, average, poo r). The median survival time within these groups was 409 days vs. 160 days vs. 91 days (p < 0.001). Conclusions: Our findings confirm the im portant role of well-known independent prognostic factors for survival in NSCLC patients, such as TNM and sex. For sodium there are no compa rable analyses at present, and therefore further investigation of this factor is needed. The proposed prognostic index appears to be a feasi ble tool to develop new treatment strategies in NSCLC.