P2-180: Prognostic factors in patients with stage IV non-small-cell lung cancer

To study incidence of metastasis of stage IV non-small cell lung cancer, and analysis prognostic and metastasis organs in non-small cell lung cancer (NSCLC) 313 patients with stage IV in NSCLC entered this study from 1999.1~2005.4 Three types of data were collected: (1) clinical features: generalized status (include sex, age, Kps, typing, pathological typing, smoking history, appetite, weight ect): TNM stage (T stage, N stage, metastasis).(2) laboratory measurements: HB, LDH, AKP, AST, ALT, BUN, CR, albumin: serum tumor marker (CEA, CYFRA211, NSE).(3) therapy measure: chemotherapy, the cycle of chemotherapy, program, cranial irradiation, bone irradiation, phosphate therapy act. Median survival time, overall survival rate, distant metastasis rate were the endpoints. Kaplan-Meier method was used for university analysis and Cox proportional hazard regression model was used for multivariate analysis. 218 and 95 patients metastases to single and different organ among the 313 cases of non-small cell (NSCLC) at stage IV. There were 63, 174, 127, 3 6, 18, 11, 5 patients with metastasis respectively to brain, bone, liver, adrenal gland, subcutaneous and others. The overall median survival time for all 313 cases of NSCLC patients was 10.8 (9.00-12.30) months and the overall 1-,2-,3-,4-and 5-year survival rates were 45%, 18%, 12%, 4%, 0%. Kaplan-Meier estimate showed that patients anatomic typing, Kps, numbers of metastasis organ, appetite, liver, adrenal gland and subcutaneous metastasis, body weight loss, smoking, index of smoking, chemotherapy, cycles of chemotherapy were the predictors of survival. Multivariate analysis showed statistically significant correlation with anatomic typing, Kps, appetite, liver and subcutaneous metastasis, body weight loss, cycles of chemotherapy. The relative risk (RR) was 1.51, 1.97, 1.55, 1.67, 2.56, and 2.56 respectively. The overall median survival time for all 313 cases of NSCLC patients was 10.8 (9.00-12.30) months and the overall 1-,2-,3-,4-and 5-year survival rates were 45%, 18%, 12%, 4% and 0%. Survival time distinctly decreased in patients who had distant metastasis more than two different organs (P<0.01= the median survival time was 7.1 months. Bone was the commonest organ to metastatic. The incidence of distant metastasis respectively was 55.59% with bone metastasis 40.58% with lung metastasis 0.13% with brain metastasis 11.50% with liver metastasis 5.75% with adrenal gland metastasis, 3.51% with subcutaneous metastasis. The survival time was shortest in subcutaneous metastasis (4.6 months), and one after another liver 7.0 months, brain 8.0 months,adrenal gland 8.6 months, bone 10.6 months, lung 11.8 months. Cox Multivariate analysis showed liver and subcutaneous metastasis, anatomic typing, Kps, appetite, body weight loss, cycles of chemotherapy were independent prognostic factors in patient with stage IV non-small cell lung cancer.