Multivariate analysis of prognostic factors in patients with small cell lung cancer

Background and objective: Multimodality treatment is the milestone of improving the prognosis of patients with small cell lung cancer (SCLC). The aim of this study is to retrospectively review the prognostic factors for SCLC. Methods: From January 1999 to June 2005, clinical data were collected from 253 patients who had a good performance status (PS=0-1) and underwent multimodality therapy (chemotherapy+ radiotherapy±surgery), and the prognostic factors were analyzed by Kaplan-Meier and COX multivariate proportional hazards model. Results: With a median follow-up of 23.2 months (3-85 months), 1-, 3-, and 5-year survival rate was 77.9%, 33.8% and 23.3% respectively, and 88.3%, 40.2%, 31.2% in LD patients, 62.9%, 22.0% and 8.8% in ED patients, respectively. Median survival time (MST) of all the patients was 23 months (95% CI: 19-27 months). Univariate analysis indicated that gender (P = 0.0395), stage (P = 0.0000), LDH (P = 0.0000), operation (P = 0.0029), weight loss (P = 0.0000) and the efficacy of first-line chemotherapy (P = 0.0000) significantly influenced survival in SCLC. Multivariate analysis suggested that gender (P = 0.019), LDH (P = 0.000), operation (P = 0.024) and weight loss (P = 0.006) were the independent prognostic factors of survival. Conclusion: Gender, LDH, operation, and weight loss are the important prognostic factors for patients with SCLC who have a good PS and undergo multimodality treatment.