BACKGROUND: Performance status (PS) is an important factor in determining survival outcome in non-small cell lung cancer (NSCLC) but is generally confounded by stage, age, gender, and smoking status. We investigated the prognostic significance of PS taking into account these important factors. METHODS: Retrospective analysis of registry database of the National Hospital Study Group for Lung Cancer (NHSGLC) between 1990 and 2005. Univariate analysis was performed using Kaplan-Meier method. Multivariate analysis was performed using Cox proportional hazards model to identify independent prognostic factors. RESULTS: A total of 26,957 patients with NSCLC were analyzed of which 12,613 patients (46.8%) had World Health Organization (WHO) PS = 0, 8,137 patients were never smokers (30.2%), and most of them were females (72.7%). The majority of PS = 0 patients presented with stage I disease (56.9%). Patients with PS = 0 constituted the group with the highest proportion of never smokers (36.7%). There was a significant difference in the median overall survival (OS) between patients with PS = 0 and PS = 1 (51.5 months versus 15.4 months, respectively; p < 0.0001) and among patients with various PS within individual American Joint Committee on Cancer stage (all p values <0.0001). Never smokers had significantly improved median OS than ever smokers (30.0 months versus 19.0 months, respectively; p < 0.0001). Multivariate analysis demonstrated good PS, never smoker (versus ever smoker; hazard ratio = 0.935, 95% confidence interval: 0.884-0.990; p = 0.0205), early stage, female gender, squamous cell carcinoma histology, and treatment were all as independent favorable prognostic factors. CONCLUSIONS: PS and smoking status are independent prognostic factors for OS in NSCLC.
BACKGROUND: Performance status (PS) is an important factor in determining survival outcome in non-small cell lung cancer (NSCLC) but is generally confounded by stage, age, gender, and smoking status. We investigated the prognostic significance of PS taking into account these important factors. METHODS: Retrospective analysis of registry database of the National Hospital Study Group for Lung Cancer (NHSGLC) between 1990 and 2005. Univariate analysis was performed using Kaplan-Meier method. Multivariate analysis was performed using Cox proportional hazards model to identify independent prognostic factors. RESULTS: A total of 26,957 patients with NSCLC were analyzed of which 12,613 patients (46.8%) had World Health Organization (WHO) PS = 0, 8,137 patients were never smokers (30.2%), and most of them were females (72.7%). The majority of PS = 0 patients presented with stage I disease (56.9%). Patients with PS = 0 constituted the group with the highest proportion of never smokers (36.7%). There was a significant difference in the median overall survival (OS) between patients with PS = 0 and PS = 1 (51.5 months versus 15.4 months, respectively; p < 0.0001) and among patients with various PS within individual American Joint Committee on Cancer stage (all p values <0.0001). Never smokers had significantly improved median OS than ever smokers (30.0 months versus 19.0 months, respectively; p < 0.0001). Multivariate analysis demonstrated good PS, never smoker (versus ever smoker; hazard ratio = 0.935, 95% confidence interval: 0.884-0.990; p = 0.0205), early stage, female gender, squamous cell carcinoma histology, and treatment were all as independent favorable prognostic factors. CONCLUSIONS: PS and smoking status are independent prognostic factors for OS in NSCLC.
Authors: Raymond H Mak; Elizabeth Doran; Alona Muzikansky; Josephine Kang; Joel W Neal; Elizabeth H Baldini; Noah C Choi; Henning Willers; David M Jackman; Lecia V Sequist Journal: Oncologist Date: 2011-05-31
Authors: Alice T Shaw; Beow Y Yeap; Benjamin J Solomon; Gregory J Riely; Justin Gainor; Jeffrey A Engelman; Geoffrey I Shapiro; Daniel B Costa; Sai-Hong I Ou; Mohit Butaney; Ravi Salgia; Robert G Maki; Marileila Varella-Garcia; Robert C Doebele; Yung-Jue Bang; Kimary Kulig; Paulina Selaru; Yiyun Tang; Keith D Wilner; Eunice L Kwak; Jeffrey W Clark; A John Iafrate; D Ross Camidge Journal: Lancet Oncol Date: 2011-09-18 Impact factor: 41.316
Authors: F Koinis; A Voutsina; A Kalikaki; A Koutsopoulos; E Lagoudaki; E Tsakalaki; E K Dermitzaki; E Kontopodis; A G Pallis; V Georgoulias; A Kotsakis Journal: Clin Transl Oncol Date: 2017-06-19 Impact factor: 3.405
Authors: V Bar-Ad; J Palmer; L Li; Y Lai; B Lu; R E Myers; Z Ye; R Axelrod; J M Johnson; M Werner-Wasik; S W Cowan; N R Evans; B T Hehn; C C Solomides; C Wang Journal: Clin Transl Oncol Date: 2016-12-01 Impact factor: 3.405
Authors: Qiuling Shi; Ju-Whei Lee; Xin Shelley Wang; Michael J Fisch; Victor T Chang; Lynne Wagner; Charles S Cleeland Journal: JCO Oncol Pract Date: 2020-05-05
Authors: Melissa J J Voorn; Loes P A Aerts; Gerbern P Bootsma; Jacques B Bezuidenhout; Vivian E M van Kampen-van den Boogaart; Bart C Bongers; Dirk K de Ruysscher; Maryska L G Janssen-Heijnen Journal: Lung Date: 2021-03-10 Impact factor: 2.584