Predictors of 5-year survival and curability in small cell lung cancer

Abstract

A retrospective analysis of various characteristics in 81 small cell lung cancer patients treated at the Mount Sinai Medical Center, New York, from 1974 to 1982 was carried out to identify factors which had prognostic significance for long-term survival, defined as actual disease-free survival for at least 5 years from initiation of therapy. Six patients, five female patients (16.7%) and one male patient (2%), including four limited disease (9.7%) and two extensive disease patients (5%) were long-term survivors (73 to 96+ months from onset of therapy), and among them three remain alive and disease-free at 84, 84, and 96 months from first treatment, respectively. Although several factors, including sex, stage of disease (limited versus extensive), and occurrence of herpes zoster predicted overall survival duration, female sex and an occurrence of herpes zoster were the only variables which were statistically significantly related to 5-year survival. Herpes zoster was a relatively late occurrence whereas female sex was an independent positive prognostic factor.

Physiological Changes Due to Age

“…Only the small-cell carcinoma responds appreciably to cytotoxic drugs with typically partial or complete response and infrequent 5-year survival (Crown et al 1990). The risk increases steadily after age 35 years in those, both men and women, smoking in excess of 1 pack of cigarettes per day for over 20 years (US Department of Health and Human Services 1989).…”

Simultaneous Disseminated Herpes Zoster and Bacterial Infection in Cancer Patients

“…The incidence of zoster, for instance, has been reported to reach 52% among patients with Hodgkin's disease (9). Herpes zoster infection has also been strongly associated with the survival of patients suffering from small cell lung cancer (10). However, its influence on the prognosis is still a controversial matter (10)(11)(12).…”

Stereological estimates of nuclear star volume and vessels as predictors of chemotherapy response in small cell carcinoma of the lung: a preliminary report

“…The outlook for these patients has improved markedly with the use of combination chemotherapy and the response rates are greater than 70% with a three‐ to fourfold increase in median survival 4‐5 . Presently, stage of disease, performance status (PS), weight loss and histological appearance 1,2,4,6‐17 are used to identify patients with a high probability of response to therapy. Current trends have been to use less intensive therapy for patients with favourable histological disease who are considered at relatively low risk while increasing the therapy for those at high risk for tumour recurrence.…”