INTRODUCTION: Understanding prognosis - especially long-term outcome - in advanced non-small-cell lung cancer(NSCLC) is crucial to inform patients, guide treatment and plan supportive and palliative care. METHODS: Prognostic factors influencing overall (OS) and progression-free survival (PFS) in 2082 patients with Wild-type(WT)-NSCLC (629 M1a, 249 M1b, 1204 M1c) are reported. Patients were included in the prospective German CRISP-registry recruiting in over 150 centers. Analysis for pretherapeutic factors was based on results from Cox proportional hazard models. RESULTS: Current M-descriptors of UICC-8 staging system were validated: M1a and M1b patients had significantly longer time to events compared to M1c (OS/PFS, medians 16.4/7.2; 17.8/6.7; 10.9/5.4 months). OS and PFS were influenced by number and location of metastatic organ systems. M1c and ≥4 metastatic organs involved had shorter OS and PFS than M1c with 1 to 3 organs (OS HR 1.69, p<001; PFS HR 1.81, p<001). M1b-liver metastases had shorter OS/PFS than M1b-involving other organs (OS HR 2.70, p=006; PFS HR 2.48, p=007). Based on number of involved organs(orgsys) and liver metastases, two risk groups (Low-risk: M1a, M1b-non-liver, M1c-1-3-orgsys-non-liver; High-risk: M1c-liver, M1b-liver, M1c-4+-orgsys) with significantly different prognosis could be amalgamated (OS/PFS, medians 14.3/6.5; 7.7/4.1 months). Other favourable factors were female gender and ECOG 0 with age showing no impact. T1- or N0-status were associated with longer OS than T2-4 or N2-3. CONCLUSION: In this large observational dataset, we further defined factors for outcome in WT-NSCLC - including increased number of involved metastatic organ systems and liver metastases - as those with overall poorer prognosis and reduced survival chance.
- Metzenmacher, M.
- Griesinger, F.
- Hummel, H. D.
- Elender, C.
- Schäfer, H.
- de Wit, M.
- Kaiser, U.
- Kern, J.
- Jänicke, M.
- Spring, L.
- Zacharias, S.
- Kaiser-Osterhues, A.
- Groth, A.
- Hipper, A.
- Zaun, G.
- Dörfel, S.
- Güldenzoph, B.
- Müller, L.
- Uhlig, J.
- Thomas, M.
- Sebastian, M.
- Eberhardt, W. E. E.
