Multivariate analysis for prognostic predictors in non-small cell lung cancer

Objective To determine the prognostic predictors for non-small cell lung cancer ( NSCLC) with multivariate analysis. Methods From 1981 to 1994, 158 patients with NSCLC had been treated by surgery alone or combined with radiotherapy and/ or chemotherapy . Their clinical characteristics were collected. All histological slides were reviewed to evaluate the histological type, tumor differentiation and vascular and lymphatic vessel invasion. Oncoprotein overexpressions were measured by immunohistochemistry assay ( ABC) , including Pan-ras, c-myc, c-erb B2, EGFR and p53. PCNA was also measured by ABC. The endpoints for prognosis consisted of survival, local control and distant metastasis. They were calculated by Kaplan-Meier method with Log-rank test determining the difference between subgroups. Cox model was used for multivariate analysis. The prognostic index ( PI) was calculated basing on the results of multivariate analysis, then the high risk group was determined by PI. Results The overall actual 5-year survival rate was 44%. The unfavorable predictors were late T and N of TNM stage ( P = 0. 025 and 2. 2) . There was significant difference in survival rate among the three groups ( P < 0. 001) , 5-year survival rate was 77%, 45% and 21%, respectively. Conclusion The unfavorable predictors are late T, late N, lymphatic vessel invasion and multi-oncoprotein overexpression. PI could be used to determine the high risk group in patients with NSCLC. DOI: 10.3779/j.issn.1009-3419.2001.06.18