Clinical prognostic factors in advanced non-small cell lung cancer (NSCLC): Cox regression analysis based on 789 patients treated in three consecutive randomized trials

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7648-7648
Author(s):  
L. R. Pilz ◽  
N. Thatcher ◽  
C. Kortsik ◽  
G. Koschel ◽  
J. Mezger ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Retrospective Analysis ◽  
Prognostic Value ◽  
Cox Regression ◽  
Performance Status ◽  
Eligibility Criteria ◽  
Cox Regression Analysis ◽  
The Impact

7648 Background: Treatment efficacy and toxicity of the three studies have been presented at ASCO (2006, Abstract # 7035). Patients (pts) received gemcitabine or docetaxel either as single agents in different schedules and doses or as a platinum free doublet. Our retrospective analysis is to identify the clinical factors which would influence patient prognosis. Methods: Patients eligibility criteria included histologically confirmed stage IIIB or IV, performance status (PS) 0–2, and no prior chemotherapy. Overall survival (OS) was similar in all three studies. 819 pts were enrolled in 1998–2004 and 798 pts of them were evaluable for this analysis: 85% of pts had stage IV disease and PS=1. Univariate and multivariate (stepwise) Cox regression analyses were performed to evaluate the impact of baseline characteristics and quality of life (QoL) on OS. Results: Factors which have a significant impact on OS are the laboratory parameters hemoglobin (HGB) and LDH (p<0.0001), WHO performance status (PS) (p=0.001) and the quality of life measure for lung cancer of the EORTC, LC13, (p=0.0006), respectively (see table ). Gender measured univariately also influences significantly OS (p=0.0085) but has less impact in the multivariate model (p=0.07). Age (<65 vs 65 and older) is not of prognostic value with OS (HR=0.92, p=0.39), as well as histology (adeno/sqamous/other) (HR=0.99, p=0.90). Other factors as tumor stage (wet IIIB vs IV), presence of extra-thoracic metastases, number of co-morbidities, and surgical and radiological pretreatment also have no prognostic influence on OS. Analysis for the effect of smoking on OS could not be performed since only few pts never smoked. Conclusions: Our retrospective analysis confirms the prognostic value of serum HGB, and LDH, WHO-PS, and QoL LC13 as clinical determinants for OS. [Table: see text] [Table: see text]

scholarly journals Impact of molecular alterations on quality of life and prognostic understanding over time in patients with incurable lung cancer: a multicenter, longitudinal, prospective cohort study

2021 ◽  
Author(s):  
Jonas Kuon ◽  
Miriam Blasi ◽  
Laura Unsöld ◽  
Jeannette Vogt ◽  
Anja Mehnert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Psychological Distress ◽  
Performance Status ◽  
Multicentric Study ◽  
Molecular Alterations ◽  
Prospective Longitudinal ◽  
The Impact ◽  
Over Time

Abstract Purpose The purpose of this study is to investigate changes over time in quality of life (QoL) in incurable lung cancer patients and the impact of determinants like molecular alterations (MA). Methods In a prospective, longitudinal, multicentric study, we assessed QoL, symptom burden, psychological distress, unmet needs, and prognostic understanding of patients diagnosed with incurable lung cancer at the time of the diagnosis (T0) and after 3 (T1), 6 (T2) and 12 months (T3) using validated questionnaires like FACT-L, National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT), PHQ-4, SCNS-SF-34, and SEIQoL. Results Two hundred seventeen patients were enrolled, 22 (10%) with reported MA. QoL scores improved over time, with a significant trend for DT, PHQ-4, and SCNS-SF-34. Significant determinants for stable or improving scores over time were survival > 6 months, performance status at the time of diagnosis, and presence of MA. Patients with MA showed better QoL scores (FACT-L at T1 104.4 vs 86.3; at T2 107.5 vs 90.0; at T3 100.9 vs 92.8) and lower psychological distress (NCCN DT at T1 3.3 vs 5; at T2 2.7 vs 4.5; at T3 3.7 vs 4.5; PHQ-4 at T1 2.3 vs 4.1; at T2 1.7 vs 3.6; at T3 2.2 vs 3.6), but also a worsening of the scores at 1 year and a higher percentage of inaccurate prognostic understanding (27 vs 17%) compared to patients without MA. Conclusion Patients with tumors harboring MA are at risk of QoL deterioration during the course of the disease. Physicians should adapt their communication strategies in order to maintain or improve QoL.

scholarly journals Prognostic value of health-related quality of life in patients with acute dyspnea

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Belkin ◽  
D Wussler ◽  
I Strebel ◽  
E Michou ◽  
N Kozhuharov ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Cox Regression ◽  
Acute Dyspnea ◽  
Cox Regression Analysis ◽  
Prognostic Accuracy ◽  
Related Quality ◽  
Health Related ◽  
Complete Set ◽  
Eq Vas

Abstract Background Previous studies have shown the prognostic value of health-related quality of life (HRQL) in stable and ambulatory chronic heart failure patients. However, it is unknown whether HRQL can predict all-cause mortality in patients presenting to the emergency department (ED) after acute onset of symptoms. In order to address this unmet need, the aim of this study was to assess the prognostic value of HRQL in patients with acute dyspnea caused by acute heart failure (AHF) and other dyspnea aetiologies for 360-day mortality. Purpose To assess prognostic value of HRQL using the generic EQ-5D and visual analogue scale (EQ VAS) in patients with acute dyspnea. Methods Basics in Acute Shortness of Breath EvaLuation (BASEL V) is a prospective, multicenter, diagnostic study enrolling adult patients presenting with acute dyspnea to the ED. For this analysis, only patients with a complete set of variables necessary for calculation of EQ-5D (range 0–10; with higher score indicating worse HRQL) and EQ VAS (range 0–100; with 100 being the best imaginable health state) at baseline were included. The endpoint was the prognostic value of EQ-5D and EQ VAS at 360 days of follow-up regarding all-cause death. Prognostic accuracy was calculated using c-statistics. In a cox regression analysis EQ-5D was treated as both, a continuous and categorical variable. Adjustments were made for clinically relevant covariates (age, sex, orthopnoea, edema, level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) at presentation, history of coronary artery disease and chronic obstructive pulmonary disease, diuretics, β-blockers and ACE-inhibitors at discharge). Results Among 2605 patients enrolled, 1141 (43,8%) had a complete set of variables allowing the calculation of EQ-5D and EQ VAS. Of these patients 594 (52.1%) had an adjudicated final diagnosis of AHF. 211 (18.5%) patients died within 360 days of follow-up. Median EQ-5D was 3 (interquartile range (IQR) 1.5–5) and median EQ VAS was 50 (IQR 40–70). The prognostic accuracy for 360-day mortality was 0.65 (95% confidence interval ((CI) 0.61–0.69) and 0.58 (95% CI 0.54–0.62) for EQ-5D and EQ VAS, respectively (p=0.002). After combining EQ-5D and EQ VAS in a logistic regression model c-statistics regarding all-cause mortality within 360 days did not improve. The prognostic accuracy of EQ-5D was comparable to that of NT-proBNP (c-statistics 0.69, p=0.385). In an adjusted cox regression analysis the hazard ratio for patients with EQ-5D &gt;4 was 2.2 (95% CI 1.7–2.9; p&lt;0.001). Conclusions In patients presenting with acute dyspnea HRQL is a strong prognostic instrument. Independently of the aetiology of the dyspnea the prognostic value of the generic EQ-5D for 360-day mortality is comparable to NT-proBNP. Patients with an EQ-5D &gt;4 are at significantly higher risk for mortality within 360 days. Figure 1. Prognostic value of HRQL Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation, Swiss Heart Foundation

A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer

Lung Cancer ◽  
2003 ◽  
Vol 40 (3) ◽  
pp. 295-299 ◽  
Author(s):  
Hazel R Scott ◽  
Donald C McMillan ◽  
Duncan J.F Brown ◽  
Lynn M Forrest ◽  
Colin S McArdle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Weight Loss ◽  
Inflammatory Response ◽  
Prospective Study ◽  
Small Cell ◽  
Small Cell Lung ◽  
A Prospective Study ◽  
The Impact

Efficacy and toxicity hypofractionated radiotherapy for centrally located non-small cell lung cancer

2021 ◽  
pp. 1-4
Author(s):  
Tanzeel Janjua ◽  
Fei Sun ◽  
Katy Clarke ◽  
Pete Dickinson ◽  
Kevin Franks ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Cox Regression ◽  
Early Stage ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Early Stage Lung Cancer ◽  
Cox Regression Analysis

Abstract Aim: Centrally located early-stage non-small cell lung cancer in patients who are unfit for surgery are treated with fractionated radiotherapy. We present the outcomes of a moderately hypofractionated accelerated dose regimen of 50 Gy in 15 fractions from a single centre in the UK. Materials and methods: Electronic case notes and radiotherapy records of lung cancer patients treated between January 2014 and December 2016 were retrospectively reviewed. Adult Comorbidity Evaluation-27 score was used to evaluate comorbidities. Mean lung doses and percentage of lung receiving more than 20 Gy were calculated for all patients. Survival outcomes were estimated using Kaplan–Meier curves. Results: Fifty-three patients were included in the study; the median follow-up was 20.2 months. 87% of patients had stage I disease. There was no 30-day post-treatment mortality. Ninety-day mortality rate after radiotherapy was 3.8%. Grade 2 pneumonitis was seen in five patients while no grade 3 or 4 pneumonitis was observed. The median progression-free survival (PFS) and overall survival (OS) were 18.5 months and 28.2 months, respectively. The estimated 1 and 2 years PFS were 62.3% and 41.3%, respectively, and OS were 77.4% and 56.6%, respectively. Worsening performance status was associated with worse survival on cox regression analysis. Disease relapsed in 36% of patients. 7.5% of patients with relapsed disease had infield recurrence. Findings: 50 Gy in 15 fractions radiotherapy for central early-stage lung cancer is a feasible choice that requires further randomised trials.

Prognostic Value of Patient Knowledge of Cancer on Quality of Life in Advanced Lung Cancer During Chemotherapy

2018 ◽  
Vol 35 (1) ◽  
pp. 93-99
Author(s):  
Krzysztof Adamowicz ◽  
Justyna Janiszewska ◽  
Monika Lichodziejewska-Niemierko
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Prognostic Value ◽  
Advanced Lung Cancer ◽  
Patient Knowledge ◽  
Knowledge Of Cancer

miR-181 Expression is Associated With The Prognosis in Lung Cancer.

2020 ◽  
Author(s):  
Yue Zhao ◽  
Xiangjun Kong ◽  
Hongbing Wang
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Prognostic Value ◽  
Cox Regression ◽  
Suppressor Gene ◽  
Rank Test ◽  
High Morbidity ◽  
Cox Regression Analysis ◽  
Log Rank Test ◽  
Cancer Tissues

Abstract Background: Lung cancer is one of the most common cancers, with high morbidity and mortality. MiRNAs are proved to play important roles in various human cancers. In our study, we aimed to explore the prognostic value of miR-181 in lung cancerMethods: Quantitative real-time polymerase chain reaction (QRT-PCR) was used to detect the expression level of miR-181 in lung cancer tissues and the paired non-cancerous tissues. The relationship between miR-181 expression and clinicopathologic parameters were analyzed by chi-square test. Kaplan-Meier method with log rank test was applied for overall survival analysis. Furthermore, the Cox regression analyses were performed to evaluate the prognostic value of miR-181 in lung cancer.Results: Down-regulated miR-181 expression was observed in lung cancer tissues (P<0.001), moreover, its expression was significantly correlated with TNM stage (P=0.015) and metastasis (P=0.000). In addition, lung cancer patients with lower miR-181 expression level had poorer overall survival than those with higher expression (log rank test, P=0.011). Cox regression analysis suggested that miR-181 was an independent prognostic factor for lung cancer (HR=1.961, 95%CI=1.135-3.388, P=0.016).Conclusion: MiR-181 may be a tumor suppressor gene in lung cancer, which can predict outcomes for the patients.

Abstract 3707: Baseline quality of life and genetic determinants and the impact on five-year lung cancer survival

2015 ◽  
Author(s):  
Jeanne A. Pierzynski ◽  
Michelle A. Hildebrandt ◽  
Yuanqing Ye ◽  
Jack A. Roth ◽  
Xifeng Wu
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Cancer Survival ◽  
Genetic Determinants ◽  
The Impact ◽  
Lung Cancer Survival

scholarly journals Long-Term Outcomes in Patients with Stroke after in-Hospital Treatment—Study Protocol of the Prospective Stroke Cohort Augsburg (SCHANA Study)

Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 280
Author(s):  
Michael Ertl ◽  
Christa Meisinger ◽  
Jakob Linseisen ◽  
Sebastian-Edgar Baumeister ◽  
Philipp Zickler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Recurrent Events ◽  
Cox Regression ◽  
University Hospital ◽  
Hospital Treatment ◽  
Invasive Treatment ◽  
Cox Regression Analysis ◽  
Relative Risks

Introduction: In Germany, stroke is the third leading cause of death, with more than 60,000 fatalities out of approximately 260,000 cases (first-ever and recurrent strokes) each year. So far, there are only a few long-term studies investigating determinants of the natural course of the disease, especially in the era of mechanical thrombectomy. Materials and Methods: The prospective single-center stroke cohort Augsburg (SCHANA) study will include about 1000 patients treated for stroke in the University Hospital of Augsburg. Patients aged 18 years or older with a confirmed diagnosis of ischemic or hemorrhagic stroke are included in the study. Information on demographic characteristics, onset of symptoms, etiologic factors, comorbidities, quality of life, invasive and non-invasive treatment, complications, and laboratory parameters are collected during a personal interview conducted during the patients’ hospital stay and via a medical chart review. About 30 mL of blood is collected from each patient, and after processing and aliquoting, all blood specimens are frozen at −80° C. The study participants will be followed-up via postal questionnaires at three and 12 months after discharge from the hospital. Furthermore, mortality follow-ups will be conducted. Cox-regression analysis will be used to estimate relative risks. Conclusion: The SCHANA study will generate comprehensive data on the long-term course of the disease. In addition to the main outcomes, recurrent events and survival, patient-oriented outcomes such as health-related quality of life and depression are the focus of the study.

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