Abstract
BACKGROUND AND OBJECTIVE: At present non-small cell lung cancer (NSCLC) is still the leading cause of death induced by cancer. The aim of this study is to investigate the prognostic factors of advanced NSCLC. METHODS: Total 1,742 cases of stage IV NSCLC data from Jan 4, 2000 to Dec 25, 2008 in Shanghai Chest Hospital were collected, confirmed by pathological examinations. Analysis was made to observe the impact of treatment on prognosis in gender, age, smoking history, pathology, classification, clinical TNM stage. Survival rate, survival difference were evaluated by Kaplan-Meire method and Logrank test respectively. The prognosis were analyzed by Cox multivariate regression. RESULTS: The median survival time of 1,742 patients was 10.0 months (9.5 months-10.5 months). One, two, three, four, and five-year survival rates were 44%, 22%, 13%, 9%, 6% respectively. The median survivals of single or multiple metastasis were 11 months vs 7 months (P < 0.001). Survival time were different in metastasic organs, with the median survival time as follows: lung for about 12 months (11.0 months-12.9 months), bone for 9 months (8.3 months-9.6 months), brain for 8 months (6.8 months-9.1 months), liver, adrenal gland, distant lymph node metastasis for 5 months (3.8 months-6.1 months), and subcutaneous for 3 months (1.7 months-4.3 months). The median survival times of adenocarcinoma (n=1,086, 62%) and squamous cell carcinoma cases (n=305, 17.5%) were 12 months vs 8 months (P < 0.001). The median survival time of chemotherapy and best supportive care were 11 months vs 6 months (P < 0.001); the median survival times of with and without radiotherapy were 11 months vs 9 months (P=0.017). CONCLUSIONS: Gender, age, gross type, pathological type, clinical T stage, N stage, numbers of metastatic organ, smoking history, treatment of advanced non-small cell lung cancer were independent prognostic factors.