Factors associated with long-term survival of patients with advanced non-small cell lung cancer
Article first published online: 21 DEC 2011
© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology
Volume 17, Issue 1, pages 134–142, January 2012
How to Cite
GIROUX LEPRIEUR, E., LAVOLE, A., RUPPERT, A.-M., GOUNANT, V., WISLEZ, M., CADRANEL, J. and MILLERON, B. (2012), Factors associated with long-term survival of patients with advanced non-small cell lung cancer. Respirology, 17: 134–142. doi: 10.1111/j.1440-1843.2011.02070.x
- Issue published online: 21 DEC 2011
- Article first published online: 21 DEC 2011
- Accepted manuscript online: 22 SEP 2011 08:46AM EST
- Received 5 May 2011; invited to revise 30 May 2011, 24 July 2011; revised 31 May 2011, 25 July 2011; accepted 27 July 2011 (Associate Editor: Paul Baas).
- advanced stage;
- long-term survival;
- maintenance therapy;
- non-small cell lung cancer
Background and objective: Only a small proportion of patients with advanced non-small cell lung cancer (NSCLC) have a life expectancy greater than 2 years. The aim of this study was to identify the factors associated with long-term survival of patients with advanced NSCLC.
Methods: Patients who had received chemotherapy for stage IIIb or IV NSCLC that was not amenable to radiotherapy were studied retrospectively. Data were gathered prospectively from a comprehensive database. Long-term survivors (>2 years) were compared with the other patients, with respect to clinical, biological and tumour–node–metastasis criteria.
Results: Data for 245 consecutive patients were collected. Thirty nine patients (15.9%) survived for more than 2 years. Long-term survivors were more likely to have had metastases at fewer sites (P = 0.008), an absence of bone metastases (P = 0.01), a performance status (PS) of 0–1 at first progression of the tumour (P = 0.002), a tumour that was controlled with first (P < 0.0001) and second-line (P = 0.004) chemotherapy, maintenance therapy (P = 0.001), curative surgery (P < 0.0001), time to first progression of the tumour of >3 months (P < 0.0001), normal LDH levels at diagnosis (P = 0.049), and a haemoglobin concentration >110 g/L at first progression of the tumour (P = 0.02). In multivariate analysis, surgery, maintenance treatment, time to first progression of the tumour of >3 months, a PS of 0–1 at first progression, the number of chemotherapy agents received, and LDH levels, were significant predictors of long-term survival.
Conclusions: Assessment of these factors, and the use of maintenance therapy, when possible, may identify a population of patients with NSCLC that is likely to have a prolonged life expectancy.