Introduction : Lung cancer is one of the most frequently occurring neoplasms and usually has a poor prognosis because most of the patients present with advanced or metastatic disease at the time of diagnosis. Similarly to non-resected non-small cell lung cancer, performance index is also a reproducible factor [8]. 150 prognostic factors pertaining to the tumor, to the patient, or to the environment. A retrospective analysis of the BR.21 trial [55], as well as a meta-analysis, confirmed that presence of KRAS mutation is a negative predictive factor for benefit of TKIs in advanced non-small cell lung (HR of 1.97, 95% CI 1.16–3.33 for KRAS mutated tumours, HR of 0.79, 95% CI 0.59–1.05 for wild-type tumours; p-value for interaction 0.003) [56]. The predictive role of RRM1 for sensitivity to gemcitabine, an antimetabolite frequently used in combination with platinum has been recently studied in the context of a randomised trial comparing cisplatin, docetaxel and gemcitabine to cisplatin–vinorelbine. The research for prognostic factors in the surgical series has shown that DFI was the important, independent, prognostic factor. A retrospective analysis of the IALT trial suggests that p27 negative characteristic may also be a predictive factor of benefit from cisplatin-based adjuvant chemotherapy [62]. dei Colli, Hosp. Given the extent and heterogeneity of the literature, many review articles addressing prognosis in lung cancer patients have attempted to identify clinically important and/or promising new prognostic factors in patients with lung cancer (for example, Buccheri and Fer- Prognosis and survival depend on many factors. Radiochemotherapy remains the standard treatment for limited stage disease. In resected patients, some publications have looked at genetic signatures, most often using small-to-moderate series of patients divided into training and validation sets. [1], in a systematic overview of prognostic factors for non-small cell lung cancer, identified 887 articles published during a decade and more than 150 possible prognostic factors for non-small cell lung cancer. Examples of scales used to evaluate performance status include the Eastern Cooperative Oncology Group (ECOG), World Health Organization (WHO) and the Karnofsky performance status scale. Response rate was 35.6%, and median survival was 8.2 months (95% CI, 7.8 to 8.7) for the whole group. They failed to show any benefit of the TKIs, although some clinical factors were suggested to be predictive of benefit: Asian, female sex, non-smoking status, non-squamous histology. The KRAS pathway links the EGFR pathway to cell proliferation and survival and KRAS mutations have been suggested as a mediating resistance to EGFR mediators. This study was devoted to identify glycolysis related genes as prognostic biomarkers for non-small cell lung cancer (NSCLC). Despite recent improvements in its treatment, the prognosis for lung cancer patients remains poor. They provide however very promising results. Pei-Pei Wang 1,4*, Si-Hong Liu 2,4*, Cun-Te Chen 3,4*, Lin Lv 1,4, Dan Li 1,4, Qiong-Yao Liu 1,4, Guo-Long Liu 1,4 , Yong Wu 1,4 . Other negative prognostic factors included increased age and men for the LD‐SCLC group and increased age, men, increased number of metastatic sites at baseline, … We do not capture any email address. Google Scholar. Most often, these factors are not reproducible and their prognostic independent value is not proven, with adjustment for well-known prognostic factors. Predictive factors are more directly useful in clinical practice as they are directly related to the efficacy of a specific treatment. Oncology, ONCOLOGY Vol 12 No 1, Volume 12, Issue 1. For example, the one published by the ELCWP has four groups distinguished by Karnofsky performance index, sex, disease extent and neutrophils count. Zhu et al. Laterality, AJCC N, AJCC T, and chemotherapy are regarded as independent prognostic factors of cancer-specific death in the Cox proportional hazards model and competing risk model. In the validation series, the four groups had respective median survival times of 19, 11, 7 and 6 months [41]. Its expression is mutually exclusive from expression of KRAS and EGFR; it has no prognostic value but it is a predictive factor for efficacy of the ALK inhibitor crizotinib. Prognostic factors of oligometastatic non-small cell lung cancer: a meta-analysis Overall, factors including age, smoking status, type of metastasis were not associated with long-term survival of oligometastatic NSCLC patients. 2. Respective median survival times range within 15–20 and 8–13 months [39]. Those signatures are not ready for use in clinical practice. Our population has a selection bias compared to the general patient population with stage IV NSCLC. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Non–small cell lung cancer stages 0 or 1 generally have a more favourable prognosis than stages 2, 3 or 4. People who are in better overall health are more likely to be able to have surgery to remove the lung cancer, which may improve survival. Among routine biological parameters, normal leukocytosis and normal neutrophil count, lactate dehydrogenase (LDH) level, calcaemia, haemoglobinaemia and albuminaemia have been identified as favourable independent prognostic factors. how well you and the cancer respond to treatment; other factors such as your age, fitness and overall health, and whether you’re currently a smoker. In fact, lung cancer patients are usually life-long smokers and present many comorbidities. In the present study, we calculated a prognostic index for predicting overall survival (OS) in NSCLC patients. European Respiratory Society442 Glossop RoadSheffield S10 2PXUnited KingdomTel: +44 114 2672860Email: journals@ersnet.org, Print ISSN: 1810-6838 J Cancer. © 2021 Canadian Cancer Society All rights reserved. Or write us. They both play a part in deciding on a treatment plan and a prognosis. Thank you for your interest in spreading the word on European Respiratory Society . If we are not able to reach you by phone, we will leave a voicemail message. Integrating several targets is also a challenge for future research. Department of Oncology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology 2. These studies have been meta-analysed and this review has shown that high metabolic activity is indeed an univariate prognostic factor (estimated hazard ratio of 2.08). EML4-ALK is most often found in never-smoking patients with lung cancer. Wahba, H. , El-Hadaad, H. , Anter, A. , Ahmad, M. and Ghazy, H. (2018) Outcomes and Prognostic Factors of Small Cell Lung Cancer: A Retrospective Study. The following are prognostic and predictive factors for lung cancer. Lung cancer is a highly malignant neoplasm with poor prognosis when diagnosed at an advanced stage, and prognostication is crucial for clinicians. For example, genetic signatures that might be very promising are not necessarily validated when adjusted for known classical prognostic factors. Introduction. Many factors may influence lung cancer survival, including gender [ 2, 3 ], diagnostic age [ 4, 5 ], histological type [ 6, 7 ], and treatment modality [ 8 – 10 ]. Eleven prognostic factors were retrospectively analyzed in 270 newly diagnosed patients with advanced non-small-cell lung cancer including age, sex, performance status, histology, stage, smoking status, hemoglobin level, forced expiratory volume in one second (FEV1), weight loss >5% in 3 months preceding therapy, number of involved organs, and type of first-line chemotherapy. The aim of the present study was to assess the outcome of lung cancer patients who were admitted to a medical intensive care unit (MICU) and to identify the measurable predictors of their MICU outcome. For example, on resected patients, Chen et al. Online ISSN: 2073-4735, Copyright © 2021 by the European Respiratory Society. The prediction results of 3- and 5-year OS rates are shown in Figure 2. Lung cancer is a leading cause of cancer-related death, and >80% of lung cancer diagnoses are non-small-cell lung cancer (NSCLC). eCollection 2021.ABSTRACTAbnormal glycolysis is one of the hallmarks of cancer and plays an important role in its development. People who have lost more than 5% of their body weight before treatment starts have a less favourable prognosis than people who haven’t lost much weight. Although chemotherapy drugs have not been developed with the hypothesis of the existence of a molecular characteristic to target, some studies have also searched to identify predictive factors that might be useful in the choice of a chemotherapy regimen. BACKGROUND/AIM: Only 0.1-0.17% of all lung cancer patients are diagnosed with stage I or II small cell lung cancer (SCLC). In more advanced non-resectable disease, a younger age might be a feature of better prognosis although competing risks might have a higher impact on mortality in older patients. Long-term survival is rare and cure rate is reached in <5% of the patients [6]. Among them, ERCC1 has been tested and it is suggested that patients with low or no ERCC1 expression do benefit from chemotherapy (HR 0.65, 95% CI 0.50–0.86) while those with high ERCC1 expression do not benefit at all (HR 1.14, 95% CI 0.84–1.55) with a significant interaction test showing that chemotherapy effect is indeed not the same across the two subgroups [60]. With small cell lung cancer, limited stage cancers have a better prognosis than extensive stage cancers. The true predictive factor was identified later [46]; the subgroup of patients who benefit in terms of progression-free survival from TKIs were those with somatic mutations in the EGFR gene (exons 19 and 21). Most of the research carried out on predictive factors in lung cancer has been devoted to non-small cell lung cancer and we will restrict this review to non-small cell lung cancer. Age ≤ 60 years, limited disease, high PNI, radiotherapy, and surgery were independent positive prognostic factors of SCLC patients treated with chemotherapy. Nomogram included all statistically significant prognostic factors in the Cox proportional hazard model, including age, sex, race, neoplastic grade, histological type, primary site, stage, LN metastasis, and surgery. Prognostic Factors and Biomarkers of Responses to Immune Checkpoint Inhibitors in Lung Cancer Andrea Bianco 1,2,*, Fabio Perrotta 3, Giusi Barra 4, Umberto Malapelle 5, Danilo Rocco 2 and Ra aele De Palma 4 1 Department of Translational Medical Sciences, University of Campania “L Vanvitelli”, 80131 Naples, Italy 2 Department of Pneumology and Oncology, A.O. The median number of factors reported to be significant in multivariate analyses per study was 2 (range, 0 to 6 factors). If you have lung cancer, you may have questions about your prognosis. Recently, within the IASLC Lung Cancer Staging Project, data concerning 12,620 small cell lung cancer cases were collected and complete clinical TNM staging was available for 3,430 cM0 patients as well as complete pathologic TNM staging for 343 cases. Numerous studies have looked at the prognostic value of tumor metabolic activity as measured by [F]-fluoro-2-deoxy-d-glucose positron emission tomography. These studies are extremely important as chemotherapy remains a cornerstone in the treatment of early or advanced non-small cell lung cancer. Given that lung cancer is one of the common cancers world-wide, the implications of focusing on quality of life as well as survival require to be understood. A clinicopathologic study based on the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary lung adenocarcinoma classification, The Insternational Association for the Study of Lung Cancer Staging Project. They can sometimes guide the therapy and identify subgroups of patients where more aggressive therapy is needed. Some prognostic classifications have been published [35, 36], integrating several independent classical prognostic factors but they need to be validated before being used in clinical practice. Furthermore, non-small cell lung cancer (NSCLC) has the highest prevalence rate but only a 14% 5-year survival rate in patients subjected to surgery ().So far, considerable progress has been made to identify the local environmental factors that promote tumor progression. It is important to know that although the statistics for lung cancer can be frightening, they are an average and may not apply to your situation. Among other classical factors easily measurable in routine, female sex, younger age, no or low weight loss, low LDH level, normal neutrophil count, normal hemoglobinaemia, as well as normal levels of NSE and CYFRA 21-1 have been mentioned as independent favourable prognostic factors [8]. Alternatively, restrictive procedures may be not enough. Indeed, histology which has not been proven to be a strong independent and reproducible prognostic factor, is predictive of the benefit of pemetrexed in non-squamous non-small cell lung cancer, irrespective of the setting; pemetrexed combined with cisplatin versus cisplatin gemcitabine in chemo-naïve patients, maintenance pemetrexed versus placebo and pemetrexed versus docetaxel in second-line treatment. The stage of lung cancer is the most important prognostic factor. They may also be able to tolerate chemotherapy and radiation better than people in poor health. 1. A meta-analysis of individual data showed that Cyfra 21-1 level has also an independent prognostic value [16]; anaemia was also shown as an independent prognostic factor in patients with cancer, especially in patients with lung cancer in a systematic quantitative review [17]. Lung cancer is the most common malignancy in the world and accounts for the majority of cancer-related mortality. The predictive value remains to be further investigated [59]. People with lung and heart problems have a less favourable prognosis when diagnosed with lung cancer. Depending on the population studied (small cell or non-small cell cancer, operable or not) other independent factors, identified in large series, improve the prediction of prognosis: sex, age, loss of weight, LDH, leukocytosis, neutrophilia, haemoglobin, serum calcium, NSE, Cyfra 21-1. Four different collaborative research groups attempted to construct prognostic classifications making use only of independent prognostic factors [41]. The pathologic staging of non–small cell lung cancer (NSCLC) is a key determinant of the patient's prognosis and the treatment options. dL−1) might be associated with a higher mortality and preoperative high Cyfra 21-1 level has been associated with higher risk of relapse [14]. Tissue tests are done on lung cancer cells during diagnosis to see if there are certain changes (mutations) to the genes of the cancer cells. Pretreatment PNI can better predict the prognosis of SCLC, especially in patients with age ≤ 60, no smoking history, … The retrospective study took place at the MICUs of a university-affiliated medical centre and involved adult lung cancer patients admitted to the MICU between January 1998 and October 2005. A predictive factor influences how a cancer will respond to a certain treatment. Introduction. Lung cancer, prognostic factors, survival, population-based, cancer registries Purpose. PNI was a good biomarker for the assessment of SCLC prognosis for its easy access, convenience to be calculated, and low consumption. Huaxia Yang 1#, Zhuoran Yao 1#, Xiaoxiang Zhou 1#, Zhongxing Bing 2, Lei Cao 2, Zhili Cao 2, Shanqing Li 2, Xuan Zhang 1, Yan Zhao 1, Xiaofeng Zeng 1, Fengchun Zhang 1, Naixin Liang 2. There are plenty of publications in the literature about biological markers not measured routinely in clinical practice. Multiplicity testing and over-fitting may prevent reproducibility of the models in external validation series. Median survival times in months were the following: IA: 26; IB: 21; IIA: 15; IIB: 12; IIIA: 13; IIIB: 11; and IV: 6. The following features have been suggested to be associated with a more favourable prognosis: p53 normal status [18]; no EGFR expression [19]; low microvessel count [20]; low VEGF expression [21]; no overexpression of c-erbB-2 [22] with an effect possibly restricted to non-squamous histology [23]; Bcl-2 expression [24]; low KI67 expression [25]; absence of KRAS mutation [26]; TTF-1 positivity [27]; high level of p16 expression [28]; low or no ERCC1 expression (advanced NSCLC treated with platinum-based chemotherapy) [29]; low class III β-tubulin expression, in resected patients [30]; low survivin expression, in resected patients only [31]; and low lymphatic microvessel density, in surgically treated patients [32]. These innovations were informed by an analysis of data from the International Association for the Study of Lung Cancer (IASLC) database that included 70,967 evaluable patients with non-small cell lung cancer and 6,189 with small cell lung cancer. Aim: Study the prognostic factors in non small-cell lung cancer. Survival and prognostic factors of lung cancer patients with preexisting connective tissue disease: a retrospective cohort study. For years, treatment of small cell lung cancer has been guided by the extension of the disease: limited disease (generally defined as a disease limited to the hemithorax of origin, the mediastinum and the supraclavicular lymph nodes which can be encompassed in a radiation field) versus extensive disease. 14-17, 20 In addition, the number of metastases, 13, 19 achievement of complete resection, 14 estrogen‐receptor status, 19 and the initial breast‐cancer stage 17 have been studied as possible prognostic factors for survival after pulmonary metastasectomy. [38] published a 15-gene signature with a larger effect in resected patients, independent from stage with an overall HR of 15.02 (95% CI 5.12–44.04) with consistent results in stage I and stage II. Performance status measures how well a person can do their daily activities and everyday tasks. The revised staging system was also tested on a larger Surveillance, Epidemiology and End Results (SEER) series of 4,884 patients diagnosed between 1998 and 2000. We will reply by email or phone if you leave us your details. Search for other works by this author on: Oxford Academic. They are however not powerful enough to be used at the individual level. With the term “targeted therapies”, we mean a treatment that is supposed to target a specific characteristic of the tumour. Rawson NSB, Peto J (1990) An overview of prognostic factors in small cell lung cancer: a report from the Subcommittee for the Management of Lung Cancer of the United Kingdom Coordinating Committee on Cancer Research. Early stages of lung cancer (stages 0 and 1) have a better prognosis than later stages (stages 2, 3 or 4). The aim of this study was to evaluate the outcomes of patients with pathological N1 non-small cell lung cancer who did not receive adjuvant chemotherapy. We will cite only those that have been studied with meta-analyses or pooled analyses of selected trials, although published data generally do not allow the study of the independent value of the possible prognostic marker. Introduction. Most of the predictive factors are molecular biological factors but this is not always the case. Br J Cancer 61:597–604 PubMed Google Scholar. PubMed. a design in which only patients harbouring the predictive characteristic are eligible for the trial) have undoubtedly proven that patients with EGFR mutation benefit from TKIs in terms of progression-free survival although the benefit on overall survival is less clear. Devoted to identify those patients for whom adjuvant chemotherapy provides a demonstrated benefit in overall survival remain extremely poor within. 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Have looked at the individual level and low consumption prognostic independent value not! Of independent prognostic factors pertaining to the tumor, to the tumor, to the of!