From the Department of Critical Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
Author's disclosure of potential conflicts of interest are found at the end of this article.
Address reprint requests to Jean-Paul Sculier, MD, PhD, Professor, Department of Critical Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), 1, rue Héger-Bordet, B-1000 Brussels, Belgium; e-mail: sculier{at}bordet.be
Overview: The International Association for the Study of Lung Cancer (IASLC) staging project conducted the largest prognostic factor study ever performed on variables related to tumor and patients characteristics. For non-small cell lung cancer (NSCLC), older age, more advanced stage, male gender, poorer performance status, and nonsquamous cell histology were significantly associated with decreased survival. For small cell lung cancer (SCLC), multivariate analysis revealed that all variables tested (performance status, extent of disease, gender, and age) were independent prognostic factors for survival. For both recursive partitioning and amalgamation analysis, taking into account all those factors has identified groups of patients with significantly different prognoses. The roles of fluorodeoxyglucose (FDG) positron emission tomography (PET) and biologic and molecular markers were assessed by systematic reviews of the literature, including meta-analyses. This approach is limited by the lack of multivariate analyses, allowing consideration of other prognostic factors. Nevertheless, univariate results showed that increased standardized uptake value of the primary tumor was a poor prognostic factor for patients with non-small cell lung cancer. These data require confirmation by adequately sized prospective studies, having survival prognosis as the primary endpoint.
