Henry Stevenson, MD; Adi F. Gazdar, MD; Ruby Phelps, AAS; R. Ilona Linnoila, MD; Daniel C. Ihde, MD; Bimal Ghosh, MD; Thomas Walsh, MD; Edward L. Woods, MD; Herbert Oie, PhD; Teresa O'Connor, MPH; Robert Makuch, PhD; Barnett S. Kramer, MD; James L. Mulshine, MD
Stevenson H, Gazdar AF, Phelps R, Linnoila RI, Ihde DC, Ghosh B, et al. Tumor Cell Lines Established in Vitro: An Independent Prognostic Factor for Survival in Non-Small-Cell Lung Cancer. Ann Intern Med. 1990;113:764-770. doi: 10.7326/0003-4819-113-10-764
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Published: Ann Intern Med. 1990;113(10):764-770.
Objective: To determine the relation between in-vitro establishment of tumor cell lines and survival in patients with non-small-cell lung cancer.
Design: Cohort study.
Setting: Single-institution tertiary care center.
Patients: One hundred twenty-three consecutive patients with non-small-cell lung cancer from whom a viable tumor specimen could be obtained.
Intervention: Tumor tissue was removed at the time of entry into a therapeutic protocol. The tumor tissue was processed in the laboratory for attempted cell-line establishment. Patients classified as potentially curable (stages I, II, and IIIA) were treated with surgical resection, radiation therapy, or a combination. Patients suitable for palliative therapy only (stages HIB and IV) were treated with radiation therapy with or without chemotherapy. Chemotherapy was based on in-vitro drug sensitivity when available. Cell-line establishment was correlated to clinical outcome.
Measurements and Main Results: Univariate analysis of survival was done using the log-rank test; multivariate analysis was done by Cox modeling step-up and step-down techniques. Cell lines were established from the tumor specimens of 25 patients (20%). Those patients experienced a median survival of 7 months compared with 18 months in patients from whom cell lines could not be established (P < 0.001). In the 61 patients with potentially curable disease, 8 patients (13%) with cell lines established had a median survival of 8 months compared with 32 months for those without cell lines established (P = 0.001). In the 62 palliative group patients, the median survival of the 17 patients (27%) from whom tumor cell lines were established was 5 months compared with 7 months for those without cell lines (P = 0.15). Multivariate analysis in both groups showed cell-line establishment to be a significant indicator of prognosis (P < 0.0001 for curable group; P < 0.01 for palliative group).
Conclusion: In-vitro tumor growth is related to decreased patient survival, which in turn reflects the biologic aggressiveness of cancers giving rise to these tumor cell lines.
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Hematology/Oncology, Pulmonary/Critical Care, Lung Cancer.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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