[Prognostic factors].

Abstract

Thanks to the knowledge of pretherapeutic factors able to explain the evolution of a disease, the clinician gets guidelines for the choice of a treatment for an individual patient and, on a population level, he receives important information for the design and interpretation of clinical studies. Our purpose, here, is to review the "classical" prognostic factors, defined as factors usable in a daily clinical practice, for survival in a population of patients with a stage III and small cell lung cancer. The first variable to be taken into account is the operability status, highly correlated to the TNM substage IIIA or IIIB. For patients who will go to surgery, relying on the literature, we don't have any definite prognostic factor. Some data suggest that histology other than squamous cell or adenocarcinoma, male sex, age greater than 65 years, low performance status or N2 disease are unfavorable characteristics. For patients who will not benefit from surgery, a good performance index is a definitely recognized favorable feature. Prediction of the prognosis could be improved by the inclusion in a model of the TNM substage, the sex, the weight loss, the LDH level in the serum. Other biological factors like hemoglobinemia or albuminemia have to be confirmed. Generally, we need prospective studies designed to validate, on large series of patients, prognostic variables or indexes on a multivariate basis.