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Estimating Survival in Patients with Non-Small-Cell Lung Cancer and Brain Metastases: A Verification of the Graded Prognostic Assessment for Lung Cancer Using Molecular Markers (Lung-molGPA)

Authors Li J, Jing W, Zhai X, Jia W, Zhu H, Yu J

Received 2 November 2020

Accepted for publication 5 February 2021

Published 2 March 2021 Volume 2021:14 Pages 1623—1631

DOI https://doi.org/10.2147/OTT.S288928

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Sanjay Singh


Ji Li,1,* Wang Jing,2,* Xiaoyang Zhai,2 Wenxiao Jia,2 Hui Zhu,2 Jinming Yu1

1Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China; 2Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Hui Zhu; Jinming Yu Tel +86-531-67626782
; +86-531-67626947
Email [email protected]; [email protected]

Purpose: A new tool based on clinical characteristics and molecular factors (Lung-molGPA) was developed to predict the survival of patients with non-small-cell lung cancer but was has not been validated. This study aims to validate the feasibility of the Lung-molGPA in NSCLC.
Patients and Methods: Patients diagnosed NSCLC between Feb 2012 and July 2018 were retrospectively reviewed and scored using the Lung-molGPA tool to compare clinical outcomes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by Cox regression analyses.
Results: A total of 618 patients (524 adenocarcinoma [ADC], 94 non-adenocarcinoma [non-ADC]) were collected. For all patients, the median survival time (MST) was 33.0 months (33.6 and 28 months in the ADC and non-ADC groups, respectively; p = 0.21). In the ADC group, the MST for patients with a Lung-molGPA score of 3.5 to 4 was more than 4 years, while the MST was only 25 months in patients scoring 0– 1, 30.0 months in patients scoring 1.5– 2, and 35.0 months for scores of 2.5– 3 (p = 0.048). For the non-ADC group, the MST for scores 0– 1, 1.5– 2, 2.5– 3, and 3.5– 4 were 12.0, 20.2, 29.0, and 33.0 months, respectively (p = 0.017).
Conclusion: Our findings provided evidence validating the Lung-molGPA score as a useful tool to determine treatment strategies and to predict prognosis. The model is still exploratory and needs to be evaluated further in combination with additional prognostic markers.

Keywords: NSCLC, GPA, brain metastasis, survival, prognosis

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