Source: International Congress 2014 – Pathology and prognostic factors of thoracic tumours
Disease area: Thoracic oncology

Abstract

BackgroundSmall cell lung cancer (SCLC) has still a poor prognosis. Performance status, weight loss and the stage of disease at time of diagnosis are accepted parameters for the prognosis. While prognostic relevance could be shown for conventional markers of inflammation like the C-reactive Protein (CRP) and the white blood cell count (WBC) in context of other malignancies, rare data exists for the lactat-dehydrogenase (LDH) as a predictor for treatment outcome in SCLC. The aim of our study was to evaluate the prognostic significance for LDH, CRP and WBC in advanced SCLC.MethodsIn our center 296 patients (161 men, 135 women) were diagnosed with advanced SCLC (stage IIIa, n=49, IIIb, n=85 and IV, n=162) between the years 2007 and 2011. The amount of WBC, CRP and LDH in serum was captured at the time of the primary diagnosis. According to the literature the following thresholds were used: LDH³300U/l (LDH+/-), for CRP ³ 10mg/dl (CRP+/-) and for WBC ³ 11G/l (WBC+/-). The groups were compared for survival.ResultsMedian overall survival (OS) for all patients was 346 days (293-399, 95%CI). The group of patients with low LDH-levels (LDH -) had a significant (p=0.006) longer survival (OS 379 d [315-443, 95%CI] than the LDH+ group (OS 248 d [188-308, 95%CI]). Similar differences were found for CRP- (OS 417 d [395-475, 95%CI] vs. CRP+ 295 d [272-318, 95%CI], p=0.012) and for the amount of WBC (OS WBC- 379 d [307-451, 95%CI] vs. WBC+ 316 d [271-361, 95%CI], p=0.019).ConclusionElevated levels of LDH, CRP and/or WBC at the time of initial diagnosis are negative prognostic factors in advanced SCLC.

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T. Weiss, J. Kollmeier, T. G. Blum, C. Boch, C. Crolow, D. Misch, S. Thiel, H. Rüssmann, T. T. Bauer (Berlin, Germany). Lactat-dehydrogenase, C-reactive protein and white blood cell count are prognostic factors in advanced small cell lung cancer (SCLC). Eur Respir J 2014; 44: Suppl. 58, 503

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