Important factors for achieving survival of five years or more in non‑small cell lung cancer patients with distant metastasis
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- Published online on: April 30, 2014 https://doi.org/10.3892/ol.2014.2107
- Pages: 327-334
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Abstract
In order to examine which factors were important for achieving a ≥5 year survival time in non‑small cell lung cancer (NSCLC) patients with distant metastasis, 268 NSCLC patients who received first‑line chemotherapy between January 2004 and December 2007 were retrospectively examined. The median survival time of the patients was 14 months, with 22 surviving for ≥5 years, 48 for ≥2 years, but <5 years, and 198 surviving <2 years. Multivariate analysis determined that never having smoked, a good performance status, relapse following thoracic surgery and intra‑thoracic metastasis were significantly favorable prognostic factors, while abdominal metastasis was a significantly poor prognostic factor. The ≥5 years and ≥2‑5 years groups had significantly more favorable prognostic factors than the <2 years group. The never‑smoked status was a particularly important factor for ≥5 years of survival. The ≥5 years and ≥2‑5 years groups achieved a significantly more favorable response to first‑line chemotherapy, and a greater number of regimens, total months of epidermal growth factor receptor (EGFR)‑tyrosine kinase inhibitor (TKI) treatment and cytotoxic agent treatment cycles compared with the <2 years group. In total, ~50% of the patients received palliative radiotherapy. In the ≥5 years group, patients with EGFR drug‑sensitive mutations achieved ≥5 years of survival mainly by EGFR‑TKI therapy, while those without EGFR mutations achieved ≥5 years of survival by continuing effective cytotoxic agents. Achievement of >5 years of survival was found to correlate with the presence of favorable prognostic factors, response to first‑line chemotherapy, provision of appropriate EGFR‑TKI therapy according to genetic testing results, continuing effective cytotoxic regimens and the use of radiotherapy as local therapy.
