Prognostic value of histology in patients with non-small cell lung cancer

Charloux, Anne; Hédelin, Guy; Dietemann, A.; Ifoundza, Thierry; Roeslin, N; Pauli, G; Quoix, Élisabeth

doi:10.1016/s0169-5002(97)00655-7

Cited by 42 publications

(30 citation statements)

References 24 publications

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“…The awareness of prognostic determinants of NSCLC may be important in both clinical trials and routine practice (Komaki et al, 1993;Charloux et al, 1997;Paesmans et al, 1997;Merrill et al, 1999). For clinical trials, stratification of randomisation on known prognostic factors is an important part of procedure.…”

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confidence: 99%

“…Up to now, the most widely accepted prognostic determinants of NSCLC are disease stage and performance status (Brechot et al, 1996;Mountain, 1997). Several other features such as male gender, age older than 60 years, nonsquamous histologies have also been reported as negative prognostic factors (Williams et al, 1981;Charloux et al, 1997). In order to define NSCLC prognostic factors, simultaneous appraisal of eventual determinants could be carried out for a large patient population.…”

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A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson's index

et al. 2005

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Treatment of non-small-cell lung cancer (NSCLC) might take into account comorbidities as an important variable. The aim of this study was to generate a new simplified comorbidity score (SCS) and to determine whether or not it improves the possibility of predicting prognosis of NSCLC patients. A two-step methodology was used.Step 1: An SCS was developed and its prognostic value was compared with classical prognostic determinants in the outcome of 735 previously untreated NSCLC patients.Step 2: the SCS reliability as a prognostic determinant was tested in a different population of 136 prospectively accrued NSCLC patients with a formal comparison between SCS and the classical Charlson comorbidity index (CCI). Prognosis was analysed using both univariate and multivariate (Cox model) statistics. The SCS summarised the following variables: tobacco consumption, diabetes mellitus and renal insufficiency (respective weightings 7, 5 and 4), respiratory, neoplastic and cardiovascular comorbidities and alcoholism (weighting ¼ 1 for each item). In step 1, aside from classical variables such as age, stage of the disease and performance status, SCS was a statistically significant prognostic variable in univariate analyses. In the Cox model weight loss, stage grouping, performance status and SCS were independent determinants of a poor outcome. There was a trend towards statistical significance for age (P ¼ 0.08) and leucocytes count (P ¼ 0.06). In Step 2, both SCS and well-known prognostic variables were found as significant determinants in univariate analyses. There was a trend towards a negative prognostic effect for CCI. In multivariate analysis, stage grouping, performance status, histology, leucocytes, lymphocytes, lactate dehydrogenase, CYFRA 21-1 and SCS were independent determinants of a poor prognosis. CCI was removed from the Cox model. In conclusion, the SCS, constructed as an independent prognostic factor in a large NSCLC patient population, is validated in another prospective population and appears more informative than the CCI in predicting NSCLC patient outcome.

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A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson's index

et al. 2005

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“…The knowledge of prognostic determinants might be important in both clinical trials and routine practice (Komaki et al, 1993;Charloux et al, 1997;Paesmans et al, 1997;Merrill et al, 1999). In the former setting, prognostic co-variables must be taken into account in survival analyses; by way of illustration, in a given randomized trial, the statement that a difference in survival is related to the effects of the treatment must be supported by a proportional hazards model demonstrating that this effect does not depend on well-known prognostic determinants (Depierre et al, 1999;Furuse et al, 1999).…”

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Brain metastases at the time of presentation of non-small cell lung cancer: a multi-centric AERIO* analysis of prognostic factors

et al. 2001

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Patients with lung cancer frequently suffer from brain metastases at the time of presentation. This condition affects approximately 10% of non-small cell lung cancer (NSCLC) patients (Newman and Hansen, 1974;Sorensen et al, 1988). Surgery is feasible only for a small proportion of these patients. Whole brain radiotherapy has been, hitherto, the generally recommended treatment in inoperable patients. The survival of NSCLC patients with brain metastases is poor, reported to be between 3 to 6 months in patients treated with medical therapies, either radiotherapy or chemotherapy (compared to 6-10 months in other advanced NSCLC (Paesmans et al, 1995;Shepherd, 1999)). Furthermore, brain metastases at the time of presentation of lung cancer seems to be a worse prognosis (Sorensen et al, 1988) than metachronous brain metastases.New therapeutic strategies are needed to improve the outcome of these patients. The knowledge of prognostic determinants might be important in both clinical trials and routine practice (Komaki et al, 1993;Charloux et al, 1997;Paesmans et al, 1997;Merrill et al, 1999). In the former setting, prognostic co-variables must be taken into account in survival analyses; by way of illustration, in a given randomized trial, the statement that a difference in survival is related to the effects of the treatment must be supported by a proportional hazards model demonstrating that this effect does not depend on well-known prognostic determinants (Depierre et al, 1999;Furuse et al, 1999). In the second setting, a therapeutic decision might be influenced by the state of prognostic variables (Komaki et al, 1993).Here we especially take a look at the prognostic significance of 2 specific serum markers, CYFRA 21-1 and neuron-specific enolase (NSE). The prognostic value of CYFRA 21-1 (a fragment of cytokeratin subunit 19) in this disease has been suggested (Pujol et al, 1993;Wieskopf et al, 1995;Brechot et al, 1997). NSE, the γ-subunit of enolase, has been widely investigated as a marker of small cell lung cancer (SCLC;Jorgensen et al, 1989). Although only a small proportion of NSCLC presented with a high NSE level, this marker might indirectly reflect; i) a neuroendocrine component of the disease in favour of tumour heterogeneity; ii) a Summary A multi-centre retrospective study involving 4 French university institutions has been conducted in order to identify routine pretherapeutic prognostic factors of survival in patients with previously untreated non-small cell lung cancer and brain metastases at the time of presentation. A total of 231 patients were recorded regarding their clinical, radiological and biological characteristics at presentation. The accrual period was January 1991 to December 1998. Prognosis was analysed using both univariate and multivariate (Cox model) statistics. The median survival of the whole population was 28 weeks. Univariate analysis (log-rank), showed that patients affected by one of the following characteristics proved to have a shorter survival in comparison with the opposite status...

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“…In some studies, squamous histology has been correlated with better prognosis and increased survival rates when compared with non-squamous histology (Vansteenkiste, 1997;Birim, 2010). Conversely, other studies have reported that nonsquamous subtype correlated with better prognosis and survival rate (Charloux et al, 1997;Sibel et al, 2010;Zuleyha et al, 2011). In some studies, including our own, histopathological subtype had no effect on patient prognosis and did not correlate with any statistically significant difference in OS rate and EFS rate (Taha et al, 2006;Sibel et al, 2010).…”

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confidence: 92%

Survival Results and Prognostic Factors in T4 N0-3 Non-small Cell Lung Cancer Patients According to the AJCC 7^thEdition Staging System

Arslan

Bozcuk²,

Gündüz³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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, and primary treatment (p=0.004) were significant. In the group receiving non-curative treatment, the median OS was 11.0 months, while it was 19.0 months in the definitive RT group and 26.6 months in the curative treatment group. There was a significant difference between the non-curative group and the groups which had definitive RT and curative operations (respectively p<0.001 and p=0.001) in terms of OS, but not between the groups which had definitive RT and curative operations. The median event free survival (EFS) rate was 9.9 months, with rates of 46% and 19% at 3 and 5 years, respectively. On univariate analysis of EFS rate with ECOG-PS, weight loss and staging, statistical significance was found only for thorax computerized tomography (CT)+18F-fluorodeoxy-glucose positron emission tomography-CT (PET-CT) use, stage and primary treatment (p<0.20). In multivariate analysis with EFS, only the primary treatment was statistically significant (p=0.001). In the group receiving non-curative treatment, the median EFS was 10.5 months while in the curative operation group it was 14.7 months. When all the primary treatment groups were taken into consideration, grade III/IV side effect swas observed in 57 patients (46.6%). Esophagitis was most prominent among those that received definitive radiotherapy. Conclusions: Independent prognostic factors among these 122 heterogeneous LA-NSCLC T4 N0-3 M0 patients were age at diagnosis, ECOG-PS, stage and primary treatment, the last also being a significant prognostic indicator of EFS. Our findings point to the importance of appropriate staging and a multidisciplinary approach with modern imaging methods in this patient group. In those with T4 lesions, treatment selection and the effective use of curative potential should be the most important goal of clinical care. (Jemal et al., 2010). Almost 85% of lung cancers fall within the non-small cell (NSCLC) subgroup and many of these are staged as stages IIIA, IIIB or IV during diagnosis Deniz Arslan et al

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Prognostic value of histology in patients with non-small cell lung cancer

Cited by 42 publications

References 24 publications

A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson's index

A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson's index

Brain metastases at the time of presentation of non-small cell lung cancer: a multi-centric AERIO* analysis of prognostic factors

Survival Results and Prognostic Factors in T4 N0-3 Non-small Cell Lung Cancer Patients According to the AJCC 7^thEdition Staging System

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Prognostic value of histology in patients with non-small cell lung cancer

Cited by 42 publications

References 24 publications

A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson's index

A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson's index

Brain metastases at the time of presentation of non-small cell lung cancer: a multi-centric AERIO* analysis of prognostic factors

Survival Results and Prognostic Factors in T4 N0-3 Non-small Cell Lung Cancer Patients According to the AJCC 7thEdition Staging System

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Survival Results and Prognostic Factors in T4 N0-3 Non-small Cell Lung Cancer Patients According to the AJCC 7^thEdition Staging System