RT Journal Article
SR Electronic
T1 Validation and comparison of several published prognostic systems for patients with small cell lung cancer
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj01111-2010
DO 10.1183/09031936.00111110
A1 M. Paesmans
A1 J.J. Lafitte
A1 J. Lecomte
A1 T. Berghmans
A1 A. Efremidis
A1 V. Giner
A1 O. Van Cutsem
A1 A. Scherpereel
A1 A.P. Meert
A1 N. Leclercq
A1 P. Van Houtte
A1 J.P. Sculier
YR 2011
UL http://erj.ersjournals.com/content/early/2011/03/21/09031936.00111110.abstract
AB To validate and compare published prognostic classifications for predicting survival of patients with small cell lung cancer.We pooled data from phase III randomised clinical trials and used Cox models for validation purposes and concordance probability estimates for assessing predictive ability.We included 693 pts. All the classifications impacted significantly survival with hazard ratios (HR) in the range 1.57–1.68 (all p<0.0001). Median survival times were for the best predicted groups from 16 to 19 months while from 6 to 7 months for the poorest groups. Most of the paired comparisons were also statistically significant. We obtained similar results when restricting the analysis to patients with extensive disease. Multivariate Cox models for fitting survival data were also published. The HRs for a single covariate derived them were : 8.23 (95% CI : 5.88–11.69), 9.46 (6.67–13.50) and, for extensive disease : 5.60 (3.13–9.93), 12.49 (5.57–28.01) and 8.83 (4.66–16.64). Concordance probability estimates ranged from 0.55 to 0.65 (overlapping confidence intervals).Published classifications are validated and suitable for use at a population level. Expectedly, prediction at an individual level remains problematic. A specific model designed for extensive disease patients does not appear to perform better.