The Value of Anatomic Staging and Other Prognostic Factors in Small Cell Lung Cancer Management: A View of European Studies.

The need to include simple laboratory indices and performance status evaluation in treatment decision making has been shown by multivariate analyses. The conventional limited-stage extensive-stage division of prognostic groups no longer provides sufficient information. Indeed, some patients in the limited-stage group have a poor prognosis and about one quarter of patients in the extensive-stage group have a better prognosis when information from performance status and pretreatment biochemistry is taken into account. There is no rational clinical need for elaborate staging procedures, eg, computed tomography scanning or bone marrow examination, in the majority of patients with small cell lung cancer. Adequate information for defining prognostic groups can be obtained by using performance status, lactate dehydrogenase, and other biochemical tests such as sodium, alkaline phosphatase, and albumin. Thereby the cost to the patient of unnecessary burdensome investigations and to health care could both be reduced.