Determinants of improved outcome in small-cell lung cancer: an analysis of the 2,580-patient Southwest Oncology Group data base.

摘要: We analyzed the 2,580-patient Southwest Oncology Group (SWOG) small-cell lung cancer data base from 1976 to 1988 in order (1) determine prognostic value of favorable demographic and tumor-related factors therapy programs using Cox multivariate analyses limited- extensive-stage disease (LD, ED), (2) define patient subgroups with significantly different survivals recursive partitioning amalgamation (RPA) analysis refine current two-stage system. models were applied 1,363 patients six LD trials: good performance status, female sex, age less than 70 years, white race, normal lactate dehydrogenase (LDH) significant independent predictors. Concurrent chemoradiotherapy was also a strong predictor survival. For 1,217 four ED trials, LDH, treatment an intensive multidrug regimen, single metastatic lesion variables model. RPA 1,137 recent trials resulted regression tree which most important split versus ED. Normal or abnormal absence presence pleural effusion, greater equal years LD, but only LDH The terminal nodes amalgamated form distinct median 19.0, 12.5, 10.5, 6.3 months (P .0001). best survival occurred for younger "true" LD: no effusion LDH. two intermediate had either still lived longer those true (elevated LDH). This suggests that although several models, smaller number can be used through RPA. emerged as highly factor, status sex did not. A refinement staging system should made if our results confirmed combined-group analysis.