Retrospective Analysis Of Prognostic Factors Of Small Cell Lung Cancer In The First Visit Of Yunnan Cancer Hospital

Objective:To analyze the factors affecting the prognosis of small cell lung cancer(SCLC)to provide a guiding basis for the prevention and treatment of small cell lung cancer in Yunnan province based on the analysis of the basic situation,disease characteristics and survival of patients with small cell lung cancer who were first diagnosed by Yunnan Cancer Hospital from January 1,2012 to December 31,2017.Methods:A retrospective analysis was performed on 1088 patients with small cell lung cancer who were firstly diagnosed in Yunnan Province Cancer Hospital between January 1,2012 and December 31,2017.Descriptive analysis and survival analysis were performed for each factor,including kaplan-meier analysis and multivariate COX regression analysis.Results:1.Descriptive analysisThe overall mean age of onset was 57.82+10.093 years.There were 936 males(86%)and 152 females(14%).749 patients(69%)were smokers.There were 600 cases(55.1%)in the right lung and 488 cases(44.9%)in the left lung at the primary site.The clinical manifestations were mainly cough(83.1%),expectoration(67.5%)and bloody sputum(28.4%).Liver(18.2%),bone(15.2%),brain(11.4%)and adrenal gland(8.8%)were the most commonly diagnosed and metastatic sites.The clinical stages were mostly stage ? and stage IV patients(88.5%).2.Survival analysis2.1 Overall survival analysisThe 1-year,2-year and 3-year survival rates of 1088 patients were 46.1%,22.3%and 13.0%respectively.2.2 Single factor Kaplan-Meier analysisSingle factor analysis showed that the following factors have remarkable effect on survival in SCLC patients,including age(P=0.006),TTF-1(P=0.000),NSE(P=0.000),CA125(P=0.000),CA153(P=0.002),CA199(P=0.015),CA242(P=0.001),CYFRA21-1(P=0.004),NA+(P=0.000),Mg2+(P=0.033)?CL-(P=0.000),osmotic pressure(P=0.000),LDH(P=0.000),treatment or not(P=0.000),veterans staging(P=0.000),TNM staging(P=0.000),Charlson Comorbidity Index(CCI)(P=0.000),age-unadjusted CCI(P=0.000),KPS score(P=0.000).2.3 Multifactor COX regression analysisThe factors with P<0.05 in the single factors analysis were brought into the multivariate COX regression analysis,and it was concluded that the factors that significantly affected the survival and prognosis of patienrs with SCLC including veterans staging(RR=0.5 70,P=0.000),treatment or not(RR=2.745,P=0.000),LDH(RR=1.330,P=0.049),CA125(RR=1.412,P=0.020).Conclusions:2.The 1-year,2-year and 3-year survival rates of 1088 patients were 46.1%,22.3%and 13.0%respectively.2.The median OS was 16.1 months in patients with local limited SCLC patienrs and 8.9 months in patients with extensive SCLC patients.3.The patients in this group had the following characteristics:(1)the most common site is the right lung,male accounted for the majority.Cough and sputum cough were the first symptoms of most patients.Phase IV with liver metastasis accounted for the majority.4.Survival prognosis of patients with SCLC is related to the veterans staging,treatment or not,CA125 and LDH.