Multivariate Analysis Of Prognostic Factorys In Patients With Extensive-Stage Disease Small Cell Lung Cancer

Objective: Lung cancer remains the largest cause of cancer deaths worldwide and the overall 5-year survival rate is only 15%. This is because the majority of the lung cancers are diagnosed at late stages and the treatment outcome is suboptimal. Small cell lung cancer accounts for about 15% -20% of lung cancer, with clinical features of rapid growth, early distant metastasis and so on. Initial treatment is sensitive to chemotherapy and radiotherapy, but rapidly acquire drug resistance, the majority of patients died of disease recurrence. the joint of chemotherapy and radiotherapy can cure partial patients in limited-stage, but for patient with extensive-stage SCLC. chemotherapy can only relieve symptoms and prolong survival.Small cell lung cancer (SCLC) represents approximately two-thirds of all bronchogenic neoplasms and is characterized by rapid growth and early dissemination. Approximately two-thirds SCLC patients have extensive stage disease(ED).The aim of this study is to retrospectively review the prognostic factors for extensive-stage SCLC.Methods: From January 1,2002 to November 30, 2010,clinical data were collected from 91 patients who had been diagnosed extensive-stage SCLC. The Kaplan-Meier and Cox regression were used to analyze the relationship between the survival after metastasized and prognostic factors. such as gender, age, smoking, performance status(PS), weight loss, serum lactate dehydrogenase levels, anemia, serum albumin level, pleural effusion, complex metastasis, treat method and respose for treatment after metastasize.Results: Univariate analysis indicated that pleural effusion, serum lactate dehydrogenase levels, performance status score(PS), treat method and response for treatment after metastasize significantly influenced the survival after metastasized in extensive-stage SCLC(P<0.05).While gender, age, smoking, anemia, serum albumin level, composite metastasis and whether weight loss have nothing to do with the survival. Multivariate analysis suggested that PS score (RR: 2.695), pleural effusion (RR: 1.855), serum lactate dehydrogenase level (RR: 1.649), response for treatment after metastasize (RR: 2.232)were the independent prognostic factors of survival.Conclusion: pleural effusion, elevated serum lactate dehydrogenase levels, Poorer performance status and response for treatment after metastasize are poor prognostic factors for patient with extensive-stage SCLC.