Alpaslan MAYADAĞLI, Taflan SALEPÇİ, Elif TORUN, Nesrin KIRAL, Banu SALEPÇİ, Ali FİDAN, Benan ÇAĞLAYAN

Effects of prognostic factors and treatment on survival in advanced non-small cell lung cancer

Ocak 2000-Aralık 2002 tarihleri arasında hastanemizde tanısı konulmuş ue takibi yapılabilen evre IIIB ve IV küçük hücreli dışı akciğer kanserli 304 olgu retrospeküf olarak incelendi. Olguların tedavi öncesi demografik, klinik ve laboratuvar verileri ile farklı tedavi modalitelerinin sağkalım üzerine etkileri araştırıldı. Olguların 31 (%10.2) 'i kadın, 273 (%89.8) 'ü erkekti ve yaş ortalaması 60.59 ± 10.73 idi. Kaplan-Meier yöntemi ile yapılan analizde medyan sağkalım 6.0 ± 0.5 (%95 CA: 5.1-6.9) ay bulundu. Oniki aylık sağkalım oranı %25.27 ± 2.99, 24 aylık sağkalım oranı ise %11.48 ± 2.77 olarak hesaplandı. Toplam 33 değişkenin kullanıldığı tek değişkenli analizde 12 değişkenin prognoz üzerine istatistiksel olarak anlamlı etkisi olduğu görüldü (p< 0.05). Kötü prognozu işaret eden bu değişkenler yaş (> 70), performans skoru (ECOG > 1), nefes darlığı, periferik lenfadenomegali (LAM), mediasten invazyonu, plevral efüzyon ve uzak metastaz varlığı; LDH, CA 19.9, CA 125 yüksekliği ue hastalara küratif (> 50 Cy) radyoterapi (RT), kemoterapi (KT) uygulanmaması idi. Cox's regresyon yöntemi kullanılarak yapılan çok değişkenli analizde ise, ileri yaş, mediasten invazyonu ve uzak metastaz varlığı bağımsız prognostik faktör olarak bulunmazken başta ECOG performans durumu (PS) > l olmak üzere (p= 0.000), KT almamış olmak (p= 0.000), küratif RT almamış olmak (p= 0.018), nefes darlığı (p= 0.035), periferik LAM (p= 0.022) ue plevral efüzyon varlığı (p= 0.043) bağımsız prognostik faktörler olarak bulundu.

İleri evre küçük hücreli dışı akciğer kanserli olgularda tedavi öncesi prognostik faktörler ve tedavinin sağkalım üzerine etkisi

In this study, 304 stage III-B and IV non-small cell lung cancer (HSCLC) cases diagnosed and followed up in our hospital between January 2000 and December 2002 are retrospectively analysed. The effects of demographic, clinical, laboratory findings and different therapeutic modalities on survival were investigated. Of the cases, 31 (10.2%) were women, 273 (89.8%) were men and mean age was 60.59 ± 10.73. Analysis by the Kaplan-Meier method revealed that median survival was 6.0 ± 0.5 (95% Cl: 5.1-6.9) months and 12 and 24-month survival rates were 25.27 ± 2.99% and 11.48 ± 2.77% respec-tively. By uniuariate analysis of 33 parameters, 12 of them were found to be effective on survival and this relationship was statistically significant (p< 0.05). These parameters indicating poor prognosis were age > 70, ECOG performance score > 1, dyspnea, peripheral lymphadenomegaly (LAM), mediastinal invasion, pleural effusion, distant metastasis, elevated serum LDH, CA 19.9, CA-125 values, not receiving curative radiotherapy (RT) (> 50 Gy) or chemotherapy (CT). A multiuariate analysis by Cox regression method revealed that advanced age, mediastinal invasion and metastatic disease were not in-dependent prognostic factors on survival whereas ECOG performance score > 1 (p= 0.000), absence of CT (p= 0.000) and curative RT (p= 0.018), dyspnea (p= 0.035), peripheral LAM (p= 0.022) and pleural effusion (p= 0.043) were independent prognostic factors on survival.

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