Long-term survivors in stage IV non-small cell lung cancer

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2005, Vol.47 (1), p.85-91
• Main Authors: Okamoto, Tatsuro, Maruyama, Riichiroh, Shoji, Fumihiro, Asoh, Hiroshi, Ikeda, Jiro, Miyamoto, Tetsuya, Nakamura, Tomomi, Miyake, Tetsuro, Ichinose, Yukito
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - therapy; Chemotherapy; Chemotherapy, Adjuvant; Combined Modality Therapy; Female; Follow-Up Studies; Health Status; Humans; Long-term survivor; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Male; Medical sciences; Middle Aged; Multimodality treatment; Neoplasm Metastasis; Neoplasm Staging; Non-small cell lung cancer; Pneumology; Prognosis; Prognostic factor; Radiotherapy; Radiotherapy, Adjuvant; Stage IV disease; Surgery; Survival Analysis; Tumors of the respiratory system and mediastinum
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2004.06.006

Background and Objectives: To determine the prognostic factors for long-term survivors (LTS) with stage IV non-small cell lung cancer (NSCLC) who had undergone various treatments. Patients and methods: From 1990 to 1999, 222 NSCLC patients with stage IV disease, who had been treated in our department, were reviewed. As the initial treatment, 135 patients (48%) were treated with chemotherapy alone, 52 patients with a combination of chemotherapy and radiotherapy, 19 patients underwent an operation with or without any other therapeutic modalities and 16 were received radiotherapy alone. Results: Seventeen (7.7%) patients survived for more than 2 years, and all but one had adenocarcinoma. Among these LTS, eight patients received surgery as the initial therapy, and 16 (94.1%) received some type of local-control therapy, including surgery or radiotherapy, during the course of their disease. Regarding the clinical characteristics between LTS and others (non-LTS), an early N status, a single metastatic site, a good performance status, and surgery for initial therapy were all found to be significantly important factors for LTS. A multivariate analysis using a logistic regression model also showed an early N status and surgical treatment to be significantly associated with LTS. Conclusions: Selected patients with an early N status may be appropriate candidates for aggressive multimodality treatment including surgery, in order to provide a long-term survival for stage IV NSCLC.