Analysis of the Prognostic Factors of Extensive Disease Small-Cell Lung Cancer Patients in Tokushima University Hospital.

H. Ogino, M. Hanibuchi, S. Kakiuchi, Atsuro Saijo, Toshifumi Tezuka, Yuko Toyoda, Makoto Tobiume, K. Otsuka, Satoshi Sakaguchi, H. Goto, K. Arisawa, Y. Nishioka
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引用次数: 10

Abstract

BACKGROUND Small-cell lung cancer (SCLC) presents aggressive clinical behavior, and its prognosis is still poor. Previously, performance status (PS), or the existence of brain, bone, or liver metastasis were reported to be unfavorable prognostic factors. Given the recent progress of treatment modalities such as radiotherapy techniques and bone modifying agents, the prognostic factors might be different from previous findings. Therefore, we analyzed the prognostic factors of extensive disease SCLC (ED-SCLC) in recent years. METHODS ED-SCLC patients treated in Tokushima University Hospital between 2010 and 2016 were analyzed. Log-rank test and the Cox proportional hazards regression model was used in univariate and multivariate analysis, respectively. RESULTS Totally, 79 patients were analyzed. In the univariate analysis, age, PS, interstitial pneumonia (IP), liver metastasis, pleural dissemination, neutrophil counts, hypoalbuminemia, hypercalcemia and several liver and biliary enzymes were identified as poor prognostic factors. In the multivariate analysis, age, PS, IP, and liver and biliary enzymes were identified. Moreover, the PS in patients with liver metastasis was significantly worsened. CONCLUSIONS In this study, we newly demonstrated that IP was a significant poor prognostic factor of ED-SCLC. Although liver metastasis was not extracted in multivariate analysis, it may have an impact on the prognosis of ED-SCLC. J. Med. Invest. 63: 286-293, August, 2016.
德岛大学医院广泛性小细胞肺癌患者预后因素分析。
背景:小细胞肺癌(small -cell lung cancer, SCLC)临床表现具有侵袭性,且预后较差。先前,表现状态(PS)或脑、骨或肝转移的存在被报道为不利的预后因素。鉴于放疗技术和骨修饰剂等治疗方式的最新进展,预后因素可能与先前的发现不同。因此,我们对近年来广泛病变SCLC (ED-SCLC)的预后因素进行了分析。方法对2010 - 2016年在德岛大学附属医院治疗的sed - sclc患者进行分析。单因素分析采用Log-rank检验,多因素分析采用Cox比例风险回归模型。结果共分析79例患者。在单因素分析中,年龄、PS、间质性肺炎(IP)、肝转移、胸膜播散、中性粒细胞计数、低白蛋白血症、高钙血症和几种肝脏和胆道酶被确定为不良预后因素。在多变量分析中,确定了年龄,PS, IP,肝脏和胆道酶。此外,肝转移患者的PS明显恶化。结论在本研究中,我们新发现IP是ED-SCLC预后不良的重要因素。虽然在多变量分析中没有提取肝转移,但它可能对ED-SCLC的预后有影响。中国医学杂志,2016年8月。
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