Prognostic factors affecting survival in cases with lung cancer [A lung cancer mapping project in Turkey (LCMPT)]

Aim: To investigate survival and prognostic factors on survival in cases with lung cancer. Method: LCMPT conducted by TTS-LPMSG included 7197 patients with primary lung cancer diagnosed in 2005. After 5 years follow up period, 4531 patients (63.0%) whose survival data could be obtained were included in this study. To estimate survival of patients, Kaplan Meier method was used. To define factors affecting survival, Log Rank test for univariate analysis and Cox regression test for multivariate analysis were used. Results: The estimated mean survival was found as 16.9 months (95% CI: 16.4-17.4), median survival is 9.0 months (95% CI: 8.6-9.3) for all patients. The 5-year survival rate was 8.9%. The 5-year survival rates as histological types were 12.1% for squamous cell carcinoma (SSC), 10.7% for large cell (LC), 7.5% adenocarcinoma (AC), and 4.3% small cell (SC) (p<0.001). Good prognostic factors found by univariate analysis were female gender, younger age, non-smoking status, upper lobe localization, normal bronchoscopy, SCC or LC histology, early stage. Poor prognostic factors were weight loss, TB sequelae, COPD, vena cava superior syndrome, cavitation of tumor, lymphangitic spread, and atelectasis. Multivariate analysis showed that age, sex, COPD, weight loss, cavitation, histology and stage were independent prognostic factors. Conclusion: Patients with lung cancer have had still short survival; diagnosis at early stages is the most important prognostic factor.