Prognostic factors in lung cancer

Abstract

Lung cancer is at present the principal cause of mortality from cancer. In spite of the appearance of more efficient chemotherapies and novel therapeutic associations that include schemes of intensified radiotherapy, survival from this disease continues to be very poor in global terms. The two fundamental groups of bronchogenic carcinoma, oat-cell lung carcinoma and non-oat-cell lung carcinoma, show different biological behaviour and responses to treatment. In both, the stage of the disease and the general state of the patient (together with other factors such as weight loss, age, sex or severe associated diseases) are the classically accepted factors with greater prognostic influence. Nonetheless, neither of them has sufficient capacity for predicting the biological aggressiveness of the tumour, nor the response to treatment. In this respect, the identification of different oncogenes and tumour suppressor genes, tumour proliferation markers, the capacity of angiogenesis or the detection of hidden micrometastasis by means of biological markers constitute a broad field of research. In the immediate future this will make it possible to determine with greater accuracy the evolution of patients and to select the optimum treatment.