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Prognostic Factors in Small Cell Lung Cancer: An Analysis of 874 Consecutive Patients

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Book cover Lung Cancer: Basic and Clinical Aspects

Part of the book series: Cancer Treatment and Research ((CTAR,volume 28))

Abstract

The introduction of combination chemotherapy for the treatment of small cell lung cancer (SCC) has resulted in substantial improvements in overall survival duration and in the chances of being alive and disease-free two to three years from diagnosis. Current trials in patients aged ≤70–75 provide average values for median survival duration and two years disease-free survival of about 14–16 months and 10–20%, respectively, for patients with limited stage disease. The corresponding figures for extensive stage disease are around 8–11 months and 1–2% [1]. The prognostic differences between patients at opposite ends of the disease spectrum are thus considerable. Although variation in prognosis is less within each of the two disease stages it is great enough to produce both false positive and false negative interpretations of results from therapeutic trials. Prognostic factors i.e. variables with a well established relationship to the prognosis serve as indicators of this uncontrollable variation.

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References

  1. Morstyn G, Ihde DC, Lichter AS, Bunn PA, Carney DN, Gatstein E and Minna JD: Small cell lung cancer 1973–1983: Early progress and recent obstacles. Int J Radiatioin Oncology Biol Phys 10:515–539, 1984.

    Article  CAS  Google Scholar 

  2. Simon R: Importance of prognostic factors in cancer clinical trials. Cancer Treat Rep 68:185–192, 1984.

    PubMed  CAS  Google Scholar 

  3. Zelen M: Strategy and alternate randomized designs in cancer clinical trials. Cancer Treat Rep 66:1095–1100, 1982.

    PubMed  CAS  Google Scholar 

  4. Stanley KE: Prognostic factors in lung cancer. In: Lung Cancer, Jospeh Aisner (ed.). Churchill Livingstone, New York, Edingburgh, London and Melbourne, 1985.

    Google Scholar 

  5. Ihde DC, Makuch RW, Carney DN, Bunn PA, Cohen MH, Matthews MJ, Minna JD: Prognostic implications of stage of disease and sites of metastases in patients with small cell carcinoma of the lung treated with intensive combination chemotherapy. Am Rev Respir Dis 123:500–507, 1981.

    PubMed  CAS  Google Scholar 

  6. Ettinger DS, Lagakos S: Phase III study of CCNU, cyclophosphamide, adriamycin, vincristine and VP-16 in small-cell carcinoma of the lung. Cancer 49:1544–1554, 1982.

    Article  PubMed  CAS  Google Scholar 

  7. Livingston RB, McCracken JD, Trauth CJ, Chen T: Isolated pleural effusion in small cell lung carcinoma: Favorable prognosis. Chest 2:208–211, 1982.

    Article  Google Scholar 

  8. Rothman KJ: Epidemiologic methods in clinical trials. Cancer 39:1771–1775, 1977.

    Article  PubMed  CAS  Google Scholar 

  9. Kalbfleisch JD and Prentice RL: The statistical analysis of failure time data. John Wiley and Sons. New York, Chichester, Brisbane, Toronto, 1980.

    Google Scholar 

  10. Andersen PK, Vaeth M: Statistik analyse of overlevelsesdata. FADL. Copenhagen, Arhus, Odense, 1984.

    Google Scholar 

  11. Cox DR: Regression models and life-tables. J Roy Stat Soc 34:187–220, 1972.

    Google Scholar 

  12. Cox DR: Analysis of binary data. Methuen, London, 1970.

    Google Scholar 

  13. Østerlind K and Andersen PK: Model for survival in small cell lung cancer. A study of prognostic factors in 874 patients treated with chemotherapy with or without irradiation. (Submitted), 1985.

    Google Scholar 

  14. østerlind K, Hansen HH, DOmbernowsky P, Hansen M, Andersen PK: Prediction of complete remission in small cell lung cancer. A clinical study of 815 patients treated with intensive chemotherapy. (Submitted), 1985.

    Google Scholar 

  15. Østerlind K, Hansen HH, Hansen M, Dombernowsky P and Andersen PK: Longterm disease free survival in small cell carcinoma of the lung. A study of clinical determinants. (Submitted), 1985.

    Google Scholar 

  16. Hansen HH, Dombernowsky P, Hirsch FR, Hansen M and Rugård J: Prophylactic irradiation in bronchogenic small cell anaplastic carcinoma. A comparative trial of localized versus extensive radiotherapy including prophylactic brain irradiation in patients receiving combination chemotherapy. Cancer 46:279–284, 1980.

    Article  PubMed  CAS  Google Scholar 

  17. Dombernowsky P, Hansen HH, Hansen M, Sørenson S, Østerlind K, Rørth M and Hansen HS: Treatment of small cell anaplastic bronchogenic carcinoma. In: II World Conference on Lung Cancer, Heine H Hansen and Per Dombernowsky (eds.). Copenhagen June 9–13, 1980. Excerpta Medica. Amsterdam-Oxford-Princeton, 1980.

    Google Scholar 

  18. Hansen M, Østerlind K, Dombernowsky P, Sørenson S, Hansen HH: Cyclic alternating chemotherapy in small cell bronchogenic carcinoma. Results of a randomized trial of 222 patients. Proc Amer Soc Clin Oncol 2:201, 1983.

    Google Scholar 

  19. Hansen HH, Dombernowsky P, Hansen M and Hirsch F: Chemotherapy of advanced small-cell anaplastic carcinoma: Superiority of a four drug combination to a three-drug combination. Ann Intern Med 89:177–181, 1978.

    PubMed  CAS  Google Scholar 

  20. Østerlind K, Sørenson S, Hansen HH, Dombernowsky P, Hirsch FR, Hansen M and Rørth M: Continuous versus alternating combination chemotherapy for advanced small cell carcinoma of the lung. Cancer Research 43:6085–6089, 1983.

    PubMed  Google Scholar 

  21. Østerlind K, Hansen HH, Rørth M, Sorenson S, Vindeløv L and Dombernowsky P: Combination chemotherapy of small cell lung cancer based on in vivo cell cycle analysis. Results of a randomized trial of 254 patients. Proc Amer Assoc Cancer Res 23:154, 1982.

    Google Scholar 

  22. The World Health Organization Histological Typing of Lung Tumors. Second Ed. WHO, Geneva, Switzerland, 1981.

    Google Scholar 

  23. Dombernowsky P, Hirsch F, Hansen HH and Hainau B: Peritoneoscopy in the staging of 190 patients with small cell anaplastic carcinoma of the lung with special reference to sub-typing. Cancer 41:2008–2012, 1978.

    Article  PubMed  CAS  Google Scholar 

  24. Hirsch FR, Hansen HH: Bone marrow involvement in small cell anaplastic carcinoma of the lung. Prognostic and therapeutic aspects. Cancer 46:206–211, 1980.

    Article  PubMed  CAS  Google Scholar 

  25. Hirsch FR, Hansen HH, Hainau B: Bilateral bone-marrow examination in the staging of small-cell anaplastic carcinoma of the lung. Acta Pathol Microbiol Scand Sect A 87:59–62, 1979.

    CAS  Google Scholar 

  26. WHO Handbook for Reporting Results of Cancer Treatment. Geneva, World Health Organization. Publication No 48, 1979.

    Google Scholar 

  27. Østerlind K, Ihde DC, Ettinger DS, Gralla RJ, Karrer K, Krauss S, Maurer LH, Rørth M, Sørenson S and Vincent R: Staging and prognostic factors in small cell carcinoma of the lung. Cancer Treat Rep 67:3–9, 1983.

    PubMed  Google Scholar 

  28. Peto R, Rike MC, Armitage P, Breslow NE, Cox DR, Howard SV, Mantel N, McPehrson K, Peto J and Smith PG: Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II Analysis and examples. Br J Cancer 35:1–47, 1977.

    Article  PubMed  CAS  Google Scholar 

  29. Stanley KE: Prognostic factors for survival in patients with inoperable lung cancer. J Natl Cancer Inst 65:25–32, 1980.

    PubMed  CAS  Google Scholar 

  30. Drzewiecki KT and Andersen PK: Survival with malignant melanoma. A regression analysis of prognostic factors. Cancer 49:2414–2419, 1982.

    Article  PubMed  CAS  Google Scholar 

  31. BMDP Statistical Software. University of California Press. Berkeley, Los Angeles, London, 1981.

    Google Scholar 

  32. Smith TL, Gehan EA, Keating MJ, Freireich EJ: Prediction of remission in adult acute leukemia. Cancer 50:466–472, 1982.

    Article  PubMed  CAS  Google Scholar 

  33. Simon R: Randomized clinical trials and research strategy. Cancer Treat Rep 66:1083–1087, 1982.

    PubMed  CAS  Google Scholar 

  34. Simon R: Patient subsets and variation in therapeutic efficacy. Br J Clin Pharmac 14:473–482, 1982.

    CAS  Google Scholar 

  35. Maurer LH and Pajak TF: Prognostic factors in small cell carcinoma of the lung: A Cancer and Leukemia Group B study. Cancer Treat Rep 65:767–774, 1981.

    PubMed  CAS  Google Scholar 

  36. Aisner J, Whitacre M, Van Echo DA, Wiernik PH: Combination chemotherapy for small cell carcinoma of the lung: Continuous versus alternating non-cross-resistant combinations. Cancer Treat Rep 66:221–230, 1982.

    PubMed  CAS  Google Scholar 

  37. Østerlind K, Andersen PK and Hansen HH: Determinants of complete remission duration in small cell lung cancer. An analysis of 217 responders treated with intensive chemotherapy. (Submitted), 1985.

    Google Scholar 

  38. Østerlind K, Hansen HH, Hansen M and Dombernowsky P: Mortality and morbidity in long-term surviving patients treated with chemotherapy with or without irradiation for small cell lung cancer. (Submitted), 1985.

    Google Scholar 

  39. Schag CC, Heinrich RL, Ganz PA: Karnofsky performance status revisited: Reliability, validity and guidelines. J Clin Oncol 2: (3) 187–193, 1984.

    PubMed  CAS  Google Scholar 

  40. Miettinen OS: Stratification by a multivariate confounder score. Am J Epidemiol 104:609–620, 1976.

    PubMed  CAS  Google Scholar 

  41. White LP: Serum enzymes. II. Glycolytic enzymes in patients with cancer and other diseases. J Natl Cancer Inst 21:671–684, 1958.

    PubMed  CAS  Google Scholar 

  42. Langvad EL: Lactate dehydrogenase isoenzymes in cancer. Akademisk Forlag. Copenhagen, 1972.

    Google Scholar 

  43. Mulshine JL, Makuch RW, Johnston-Early A, Matthews MJ, Carney DN, Ihde DC, Cohen MH, Bates HR, Dunnick NR, Minna JD, Bunn Jr PA: Diagnosis and significance of liver metastases in small cell carcinoma of the lung. J Clin One 2:733–741, 1984.

    CAS  Google Scholar 

  44. Elliott JA, Østerlind K, Hirsch FR and Hansen HH: Metastatic patterns in small cell lung cancer: Correlation of autopsy findings with clinical parameters in 537 patients. (J Clin Oncol, in press), 1985.

    Google Scholar 

  45. Østerlind K, Hansen M, Hansen HH and Dombernowsky P: Benefit of surgical resection prior to chemotherapy in small cell lung cancer? A study of 407 stage MO patients. (Submitted), 1985.

    Google Scholar 

  46. Goldie JH, Goldman AJ and Gudanskas GA: Rationale for the use of alternating non-cross-resistant chemotherapy. Cancer Treat Rep 66:439–449, 1982.

    PubMed  CAS  Google Scholar 

  47. Goldie JH, Coldman AJ: Quantitative model for multiple levels of drug resistance in clinical tumors. Cancer Treat Rep 67:923–931, 1983.

    PubMed  CAS  Google Scholar 

  48. Skipper HE, Schabel Jr FM: Tumor stem cell heterogeneity: Implications with respect to classification of cancers by chemotherapeutic effect. Cancer Treat Rep 68:43–61, 1984.

    PubMed  CAS  Google Scholar 

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© 1986 Martinus Nijhoff Publishers, Boston

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Østerlind, K. (1986). Prognostic Factors in Small Cell Lung Cancer: An Analysis of 874 Consecutive Patients. In: Hansen, H.H. (eds) Lung Cancer: Basic and Clinical Aspects. Cancer Treatment and Research, vol 28. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2295-5_8

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  • DOI: https://doi.org/10.1007/978-1-4613-2295-5_8

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-9414-6

  • Online ISBN: 978-1-4613-2295-5

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