Prognostic factors in stage III non-small-cell lung cancer

PURPOSE: The aim of this study is to present an analysis investigating the association of patient characteristics with overall survival (OS) in individuals with stage III non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Ten prognostic factors were analyzed in 203 patients with NSCLC who were enrolled in a phase III trial conducted by the Hoosier Oncology Group and US Oncology between 2002 and 2006. Eligible patients had untreated stage III NSCLC, forced expiratory volume in one second (FEV₁) ≥ 1 liter, baseline performance status of 0/1, and weight loss < 5% in 3 months preceding the trial. Univariate analysis, Cox proportional hazards regression, and parametric accelerated failure time models were performed to identify the factors that affected survival duration. Variables analyzed included age (< 70 years vs. ≥ 70 years), sex, ethnicity, body mass index, performance status (0 vs. 1), FEV₁ (> 2 L vs. 1-2 L), smoking status (current vs. never/former), hemoglobin (Hb) level, use of positron emission tomography scan in staging, and stage (IIIA vs. IIIB). RESULTS: Median follow-up was 25.6 months and the median OS was 21.2 months. The univariate analysis showed that Hb levels ≥ 12 were associated with an improved survival (P = .033). The multivariable parametric accelerated failure time model demonstrated the association of FEV₁ > 2 L (P = .014), and higher pretreatment Hb values (P = .007) as independent prognostic factors for OS. Similarly in the Cox regression, survival was influenced by Hb and FEV₁ > 2 L. CONCLUSION: This analysis suggests that FEV₁ > 2 L and higher pretreatment Hb values are associated with improved OS in patients with stage III NSCLC. These factors can be useful in predicting for more favorable outcomes in patients with stage III NSCLC and provide additional information when designing future studies.