Table 1
Patient characteristics regarding the disease stage
| Variable | ED-SCLC (n = 80) | LD-SCLC (n = 60) | p-values |
|---|---|---|---|
| Age (years) x̄ (SD) | 63.2 (9.1) | 63.0 (9.4) | 0.930 |
| Gender | |||
| Male | 55 (68.8%) | 34 (56.7%) | 0.159 |
| Female | 25 (31.2%) | 26 (43.4%) | |
| Smoking | |||
| Yes | 77 (96.2%) | 57 (95.0%) | 1.000 |
| No | 3 (3.8%) | 3 (5.0%) | |
| PS (ECOG) 0–1 | 64 (80.0%) | 52 (86.7%) | 0.368 |
| 2–3 | 16 (20.0%) | 8 (13.3%) | |
| Chest irradiation | |||
| Yes | 9 (11.2%) | 36 (60.0%) | < 0.0001 |
| No | 71 (88.8%) | 24 (40.0%) | |
| PCI | |||
| Yes | 2 (2.5%) | 10 (16.7%) | 0.004 |
| No | 78 (97.5%) | 50 (83.3%) | |
| Disease control | |||
| Yes | 63 (78.8%) | 56 (93.3%) | 0.018 |
| No | 17 (21.2%) | 4 (6.7%) | |
| PFS (weeks) x̄ (SD) | 30.1 (14.5) | 60.3 (57.9) | < 0.0001 |
| OS (weeks) x̄ (SD) | 48.3 (23.4) | 83.3 (59.3) | < 0.0001 |
| Outcome | |||
| dead | 79 (98.8%) | 46 (76.7%) | 0.013 |
| alive | 1 (1.2%) | 14 (23.3%) | |
| WBC count (x 109/l) x̄ (SD) | 9.1 (3.7) | 9.2 (3.3) | 0.686 |
| Platelet count (x | |||
| 109/l) x̄ (SD) | 293 (119) | 304 (95) | 0.249 |
| Hemoglobin (g/l) x̄ (SD) | 130.9 (17.8) | 133.0 (16.8) | 0.540 |
| CRP (mg/l) x̄ (SD) | 34.2 (44.6) | 21.2 (26.6) | 0.048 |
| Creatinine (umol/l) x̄ (SD) | 81.9 (20.0) | 82.3 (29.6) | 0.443 |
| LDH (U/l) x̄ (SD) | 336.2 (193.5) | 311.1 (607.3) | 0.004 |
| Lymphocytes (x | |||
| 109/l) x̄ (SD) | 1.6 (0.8) | 1.7 (0.7) | 0.202 |
| Neutrophils (x 109/l) x̄ (SD) | 6.6 (3.4) | 6.6 (3.2) | 0.812 |
| Monocytes (x109/l) x̄ (SD) | 0.7 (0.3) | 0.7 (0.3) | 0.700 |
| NLR x̄ (SD) | 5.1 (3.6) | 4.6 (3.4) | 0.485 |
| PLR x̄ (SD) | 217.9 (119.9) | 213.4 (123.3) | 0.714 |
| LMR x̄ (SD) | 2.5 (1.4) | 3.0 (2.4) | 0.271 |
[i] CRP = C-reactive protein; ECOG = Eastern Cooperative Oncology Group; ED-SCLC = extensive-stage disease small cell lung cancer; LDH = lactate dehydrogenase; LD-SCLC = limited-stage disease small cell lung cancer; LMR = lymphocyte-to-monocyte ratio; NLR = neutrophil-to-lymphocyte ratio; OS = overall survival; SD = standard deviation; PCI = prophylactic cranial irradiation; PFS = progression- free survival; PLR = platelet-to-lymphocyte ratio; PS = performance status; WBC = white blood cells; x = arithmetic mean
Table 2
Prognostic parameters for survival – all patients
| Variable | No. of patients | Median survival (weeks) - 95% CI | p-values (log-rank test) | |
|---|---|---|---|---|
| Extent of disease | LD ED | 60 80 | 64.1 (56.7–71.6) 45.7 (42.3–49.2) | < 0.0001 |
| Chest irradiation | Yes No | 45 95 | 69.1 (63.3–75.0) 45.3 (39.0–51.6) | < 0.0001 |
| PCI | Yes No | 12 128 | 69.0 (12.3–125.7) 49.1 (43.4–54.9) | 0.003 |
| Disease control | Yes No | 119 21 | 53.4 (49.5–57.3) 36.4 (25.3–47.5) | 0.013 |
| Hemoglobin (g/l) | M ≥ 138 F ≥ 119 < 138 < 119 | 78 62 | 57.1 (50.6–63.6) 40.6 (28.9–52.3) | 0.006 |
| CRP (mg/l) | < 5.0 ≥ 5.0 | 35 104 | 57.1 (48.9–65.4) 47.9 (41.4–54.3) | 0.026 |
| LDH (U/l) | < 241 ≥ 241 | 55 56 | 63.0 (53.0–73.0) 37.0 (27.7–46.3) | 0.002 |
| Monocytes (x109/l) | ≤ 0.84 > 0.84 | 99 41 | 55.0 (49.5–60.5) 44.3 (33.2–55.4) | 0.048 |
Table 3
Prognostic parameters for survival – extensive-stage disease (ED)
| Variable | No. of patients | Median survival (weeks) - 95% CI | p-values (log-rank test) | |
|---|---|---|---|---|
| Skin metastases | Yes No | 4 76 | 15.9 (0.7–31.0) 46.9 (42.7–51.0) | < 0.0001 |
| LDH (U/l) | < 241 ≥ 241 | 26 36 | 54.0 (45.4–62.6) 33.7 (22.8–44.6) | 0.017 |
| NLR | < 4 ≥ 4 | 40 40 | 50.1 (43.5–56.8) 44.7 (37.4–52.0) | 0.026 |
| NLR | < 5 ≥ 5 | 50 30 | 50.1 (44.7–55.6) 39.6 (30.7–48.5) | 0.036 |
Table 4
Prognostic parameters for survival – limited-stage disease (LD)
| Variable | No. of patients | Median survival (weeks) - 95% CI | p-values (log-rank test) | |
|---|---|---|---|---|
| PS (ECOG) | 0–1 2–3 | 52 8 | 66.3 (57.6–75.0) 35.9 (8.3–63.4) | 0.007 |
| Chest irradiation | Yes No | 36 24 | 70.7 (51.8–89.6) 36.7 (16.1–57.3) | 0.003 |
| PCI | Yes No | 10 50 | 102.0 (0.0–209.6) 58.3 (46.7–69.8) | 0.032 |
| Hemoglobin (g/l) | M ≥ 138 F ≥ 119 < 138 < 119 | 35 25 | 71.9 (57.0–86.8) 54.3 (17.7–90.9) | 0.033 |
| Creatinine (umol/l) | M < 125 F < 107 ≥ 125 ≥ 107 | 57 3 | 66.3 (58.6–74.0) 32.9 (27.8–37.9) | 0.001 |
Table 5
Results of Cox regression analysis
| Variable | HR | 95.0% CI for HR | p-value | ||
|---|---|---|---|---|---|
| ED-SCLC | Lower | Upper | |||
| Skin metastases | Yes vs No | 0.034 | 0.006 | 0.192 | 0.000 |
| LDH | < 241 vs. ≥ 241 | 1.691 | 1.130 | 2.530 | 0.011 |
| Monocytes | ≤ 0.84 vs. > 0.84 | 1.057 | 0.675 | 1.655 | 0.809 |
| NLR | < 4 vs. ≥ 4 | 1.497 | 0.757 | 2.961 | 0.246 |
| NLR | < 5 vs. ≥ 5 | 0.795 | 0.391 | 1.615 | 0.525 |
| LD-SCLC | |||||
| ECOG | 0–1 vs. 2–3 | 2.865 | 1.032 | 7.953 | 0.043 |
| Chest irradiation | Yes vs. No | 1.558 | 0.793 | 3.047 | 0.195 |
| PCI | Yes vs. No | 2.038 | 0.893 | 4.654 | 0.091 |
| Hemoglobin | Normal vs. Anemia | 1.439 | 0.773 | 2.678 | 0.251 |
| Creatinine | Normal vs. Elevated | 1.432 | 0.155 | 13.198 | 0.751 |
[i] CI = confidence interval; ECOG = Eastern Cooperative Oncology Group, ED-SCLC = extensive-stage disease small cell lung cancer; HR = hazard ratio; LDH = lactate dehydrogenase; LD-SCLC = limited-stage disease small cell lung cancer; NLR = neutrophil-to-lymphocyte ratio; PCI = prophylactic cranial irradiation
Figure 1
Probability of survival of all patients according to stage (p < 0.0001).
Figure 2
Probability of survival of extensive-stage disease small cell lung cancer patients according to neutrophil-to-lymphocyte ratio (NLR) cut-off 4 (p = 0.026) and NLR cut-off 5 (p = 0.036).