LABORATORY PARAMETERS AS AN ALTERNATIVE TO PERFORMANCE STATUS IN PROGNOSTIC STRATIFICATION OF PATIENTS WITH SMALL CELL LUNG-CANCER

Abstract

Pretreatment performance status (PS) is a major prognostic factor for treatment response and survival duration in cancer clinical trials. PS is a subjective index that may be markedly influenced by acute self-limited events. A prognostic index, based on pretreatment laboratory results, that might serve as an alternative to PS in patients with small cell anaplastic lung cancer was developed. Results were analyzed in 56 newly diagnosed patients with a minimum follow-up of 10 mo. and a median follow-up of 21 mo. Patients were divided into high and low groups for each laboratory parameter based on readings above or below the median value. Patients with high Hb or albumin levels or low serum .alpha.-1 globulins, .gamma.-1 globulins or LDH [lactic dehydrogenase] survived significantly longer than patients with the opposite levels. When these factors were evaluated by multivariate analysis, albumin and Hb were the most influential prognostic factors for survival. After inclusion of these 2 laboratory parameters, PS was no longer a significant prognosticator of survival. An objective prognostic index based on pretreatment laboratory results appears feasible in patients with small cell lung cancer.