The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer

The relationship between the magnitude of systemic inflammatory response and the nutritional/functional parameters in patients with inoperable non-small cell lung cancer were studied. The extent of weight loss, albumin, C-reactive protein, performance status and quality of life was measured in 106 patients with inoperable non-small cell lung cancer (stages III and IV). Survival analysis was performed using the Cox proportional hazard model. The majority of patients were male and almost 80% had elevated circulating C-reactive protein concentrations (> 10 mg l(-1)). On multivariate analysis, age (P=0.0 12), tumour type (0,002), weight loss (P=0.056), C-reactive protein (P=0.047), Kannofsky performance status (P=0.002) and fatigue (P=0,046) were independent predictors of survival. The patients were grouped according to the magnitude of the C-reactive protein concentrations (less than or equal to 10, 11 - 100 and > 100 mg l(-1)). An increase in the magnitude of the systemic inflammatory response was associated with increased weight loss (P=0.004), reduced albumin concentrations (P=0.00 1), reduced performance status (P=0.060), increased fatigue (P=0.011) and reduced survival (HR 1.936 95%Cl 1.414-2.650, P<0.001). These results indicate that the majority of patients with inoperable non-small cell lung cancer have evidence of a systemic inflammatory response. Furthermore, an increase in the magnitude of the systemic inflammatory response resulted in greater weight loss, poorer performance status, more fatigue and poorer survival. (C) 2002 Cancer Research UK.