The impact of severe lung cancer on survival of non-small cell lung cancer

<bold>Background:</bold> Severe lung cancer (SLC) refers to patients whose performance status (PS) is poor (between 2 and 4) but can be improved due to the recovery of salvageable but life-threatening causes (i.e. morbidities, tumor-caused events, and treatment-related advanced events), which is novel concept receiving international expert consensus. Critical status (CS) refers to the course of poor PS resulting from causes mentioned above. Little is known about impact of SLC on non-small cell lung cancer (NSCLC). <bold>Methods:</bold> The retrospective study enrolled 247 NSCLC patients. Kaplan-Meier method was used to estimate overall survival (OS, primary endpoint). Cox regression analyses ascertained variables related to OS. <bold>Results:</bold> 58(23.5%) out of 247 patients met initial CS during their clinical course. 40(68.9%) out of 58 patients recovered after definite therapy, identified as SLC. No significant difference was observed in baseline characteristics except gender between SLC(40/58) <italic>vs</italic> non-SLC(18/58) patients. Median follow-up was 19.4 months. Developing CS was an independent risk factor related to OS after Cox regression analyses (hazard ratio, 17.1[95%CI, 4.9-58.3]; <italic>p</italic><0.001). Compared to a median OS of 0.76 (95%CI 0.56-0.97) months of non-SLC patients, OS was significantly improved in SLC (<italic>p</italic><0.001). <bold>Conclusion:</bold> Occurrence of initial CS gained significant OS hindrance for NSCLC and therapy for cause of SLC improved OS, warranted for further well-designed study. <fig><object-id>erj;64/suppl_68/PA3492/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>