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Factors associated with long-term survival of patients with advanced non-small cell lung cancer

Authors

  • ETIENNE GIROUX LEPRIEUR,

    Corresponding author
    1. Thoracic Oncology Unit, Respiratory Diseases Department, Tenon Hospital, APHP and Paris VI University, Paris
    2. Respiratory Diseases Department, Ambroise Paré Hospital, APHP and Versailles—Saint Quentin en Yvelines University, Boulogne-Billancourt, France
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  • ARMELLE LAVOLE,

    1. Thoracic Oncology Unit, Respiratory Diseases Department, Tenon Hospital, APHP and Paris VI University, Paris
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  • ANNE-MARIE RUPPERT,

    1. Thoracic Oncology Unit, Respiratory Diseases Department, Tenon Hospital, APHP and Paris VI University, Paris
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  • VALéRIE GOUNANT,

    1. Thoracic Oncology Unit, Respiratory Diseases Department, Tenon Hospital, APHP and Paris VI University, Paris
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  • MARIE WISLEZ,

    1. Thoracic Oncology Unit, Respiratory Diseases Department, Tenon Hospital, APHP and Paris VI University, Paris
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  • JACQUES CADRANEL,

    1. Thoracic Oncology Unit, Respiratory Diseases Department, Tenon Hospital, APHP and Paris VI University, Paris
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  • BERNARD MILLERON

    1. Thoracic Oncology Unit, Respiratory Diseases Department, Tenon Hospital, APHP and Paris VI University, Paris
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Etienne Giroux Leprieur, Respiratory Diseases Department, Ambroise Paré Hospital, 9 avenue du Général de Gaulle, 92100 Boulogne-Billancourt, France. Email: etienne.giroux-leprieur@apr.aphp.fr

ABSTRACT

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.

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