Prognostic Factors in Stage III Non–Small-Cell Lung Cancer

Abstract

PURPOSEThe aim of this study is to present an analysis investigating the association of patient characteristics with overall survival (OS) in individuals with stage III non–small-cell lung cancer (NSCLC). PATIENTS AND METHODSTen prognostic factors were analyzed in 203 patients with NSCLC who were enrolled in a phase III trial conducted by the Hoosier Oncology Group and US Oncology between 2002 and 2006. Eligible patients had untreated stage III NSCLC, forced expiratory volume in one second (FEV1) ≥ 1 liter, baseline performance status of 0/1, and weight loss <5% in 3 months preceding the trial. Univariate analysis, Cox proportional hazards regression, and parametric accelerated failure time models were performed to identify the factors that affected survival duration. Variables analyzed included age (< 70 years vs. ≥ 70 years), sex, ethnicity, body mass index, performance status (0 vs. 1), FEV1 (> 2 L vs. 1-2 L), smoking status (current vs. never/former), hemoglobin (Hb) level, use of positron emission tomography scan in staging, and stage (IIIA vs. IIIB). RESULTSMedian follow-up was 25.6 months and the median OS was 21.2 months. The univariate analysis showed that Hb levels ≥12 were associated with an improved survival(P = .033). The multivariable parametric accelerated failure time model demonstrated the association of FEV1 > 2 L (P = .014), and higher pretreatment Hb values (P = .007) as independent prognostic factors for OS. Similarly in the Cox regression, survival was influenced by Hb and FEV1 > 2 L. CONCLUSIONThis analysis suggests that FEV1 > 2 L and higher pretreatment Hb values are associated with improved OS in patients with stage III NSCLC. These factors can be useful in predicting for more favorable outcomes in patients with stage III NSCLC and provide additional information when designing future studies.