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Table 4 Modifiable prognostic factors evaluated by included reviews

From: Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar

Author, year*

REV ID

Patient population

PF code

Description

Study design

Evaluable studies

Sample size range

Summary measure

Pooled analysis

Narrative synthesis***

Patient characteristics

 Carter, 2014

5362

NSCLC (III–IV)

BMI

Less weight loss or normal BMI

Retrospective

21

NS

NS

 

+ in 11 studies;

<> in 10 studies

 Berghmans, 2011

8434

NSCLC (III)

BMI

Body mass index

NS

NS

NS

NS

 

+ in 1 study;

<> NS

 Berghmans, 2011

8434

NSCLC (III)

Weight loss

Weight loss (no further details)

NS

NS

NS

NS

 

+ in 5 studies;

<> NS

 Brundage, 2002

1051

NSCLC (early)

Weight loss

No substantial weight loss

NS

6

55–207

NS

 

<> in 6 studies

 Aboshi, 2014**

182

NSCLC (late)

PS

Percentage of patients in study with ECOG PS1 < 60 (vs ≥ 60)

Prospective

13

39–1217

OR

<>

 

 Berghmans, 2011

8434

NSCLC (III)

PS

Good performance status

NS

NS

NS

NS

 

+ in 13 studies;

<> NS

 Brundage, 2002

1051

NSCLC (early)

PS

High performance status

NS

13

69–408

NS

 

+ in 4 studies;

<> in 9 studies

 Carter, 2014

5362

NSCLC (III–IV)

PS

Better PS, ECOG 0-1/KPS < 70 (vs ≥ 2, or vs ≥ 80)

Retrospective

47

NS

NS

 

+ in 36 studies;

<> in 11 studies

 Berghmans, 2011

8434

NSCLC (III)

QoL

Quality of life (no further details)

NS

NS

NS

NS

 

+ in 1 study;

<> NS

 Montazeri, 2009**

703

mxdC (LC)

QoL

Pre-treatment (baseline) quality of life

NS

26

30–651

NS

 

+ in 24 studies;

<> in 2 studies

 Montazeri, 2009**

703

mxdC LC (NSCLC)

Qol

Pre-treatment (baseline) quality of life

NS

11

30–573

NS

 

+ in 10 studies;

<> in 1 study

 Montazeri, 2009**

703

mxdC LC (SCLC)

Qol

Pre-treatment (baseline) quality of life

NS

1

70

NS

 

<> in 1 study

 Carter, 2014

5362

NSCLC (III–IV)

QoL

Better pre-treatment health related QoL/fewer symptoms

Retrospective

6

NS

NS

 

+ in 6 studies

 Berghmans, 2011

8434

NSCLC (III)

Smoking status

Smoking (no further details)

NS

NS

NS

NS

 

+ in 1 study;

<> NS

 Brundage, 2002

1051

NSCLC (early)

Smoking status

Smoking habit (no further details)

NS

23

50–593

NS

 

+ in 2 studies;

<> in 21 studies

 Florou, 2014**

51

mxdC LC (limited SCLC)

Smoking status

Non-smoker—during treatment (vs smoker)

Retrospective

1

215

NS

 

+ in 1 study

 Florou, 2014**

51

mxdC LC (limited SCLC)

Smoking status

Ex-smoker—at or after diagnosis (vs current smoker)

Prospective

1

284

NS

 

+ in 1 study

 Florou, 2014**

51

mxdC LC (early NSCLC)

Smoking status

Ex-smoker—quit smoking before diagnosis (vs current smoker or never smoked)

Prospective

1

543

NS

 

<> in 1 study;

 Florou, 2014**

51

mxdC LC (early NSCLC/limited SCLC)

Smoking status

Never smoked (vs ex- or current smoker)

Prospective

2

284–238

NS

 

<> in 1 study;

+ in 1 study

 Parsons, 2010

695

NSCLC (mainly I–IIIA)

Smoking status

Continued smoking after diagnosis (vs quit smoking) in NSCLC

Mixed

4

93–311

HR

<> (unadj);

− (adj, n=1)

 

 Parsons, 2010

695

SCLC (mainly limited)

Smoking status

Continued smoking after diagnosis (vs quit smoking) in SCLC

Retrospective

2

70–611

HR

−

 

 Carter, 2014

5362

NSCLC (III–IV)

Smoking status

Less/no smoking status

Retrospective

9

NS

NS

 

+ in 6 studies;

<> in 3 studies

Healthcare provider and system

 Slatore, 2010**

621

LC

Insurance status

Medicaid (vs private, non-Medicaid, or other funded)

NS

4

3702–13,469

HR/OR

 

− in 4 studies

 Slatore, 2010**

621

LC (NSCLC)

Insurance status

Commercial or other insurance (vs private insurance)

NS

2

336–1403

HR/OR

 

<> in 2 studies

 Slatore, 2010**

621

LC

Insurance status

Medicaid/Medicare (vs Medicare)

NS

2

3094–26,073

HR

 

− in 2 studies

 Slatore, 2010**

621

LC (NSCLC)

Insurance status

Medicaid/Medicare (vs Medicare)

NS

1

3,094

HR

 

− in 1 study

 Slatore, 2010**

621

LC

Insurance status

Medicare HMO (vs Medicare Fee for Service)

NS

1

10,229

HR

 

<> in 1 study

 Prades, 2015**

5807

mxdC (NSCLC)

MDT

MDT patient management

Prospective

1

NS

Survival rate

 

+ in 1 study

 von Meyenfeldt, 2012**

414

LC

Procedural volume

High hospital annual volume of surgical resections (vs low volume)—post-operative mortality

NS

11 (10 in MR)

987–90,088

OR

+

+ in 6 studies;

<> in 5 studies

 von Meyenfeldt, 2012**

414

LC

Procedural volume

High hospital annual volume of surgical resections (vs low volume)—overall survival

NS

8 (7 in MR)

1097–40,754

HR

<>

+ in 5 studies;

− in 1 study;

<> in 2 studies

 von Meyenfeldt, 2012**

414

LC

Procedural volume

High annual surgeon procedural volume (vs low volume)—post-operative mortality

NS

2

4841–24,092

HR

<>

+ in 2 studies

 von Meyenfeldt, 2012**

414

LC

Surgeon

Surgeon specialty: general thoracic surgeon (vs general surgeon)—post-operative mortality

NS

3

19,745–86,538

HR

+

+ in 1 study;

<> in 2 studies

 von Meyenfeldt, 2012**

414

LC

Surgeon

Surgeon specialty: general thoracic surgeon (vs general surgeon)—overall survival

NS

2

1097–19,745

OR

<>

+ in 1 study;

<> in 1 studies

 von Meyenfeldt, 2012**

414

LC

Surgeon

Surgeon specialty: cardiothoracic surgeon (vs general surgeon)—post-operative mortality

NS

3

19,745–86,538

OR

+

+ in 1 study;

<> in 2 studies

 von Meyenfeldt, 2012**

414

LC

Surgeon

Surgeon specialty: cardiothoracic surgeon (vs general surgeon)—overall survival

NS

2

1097–19,745

HR

 

+ in 1 study;

<> in 1 studies

 Olsson 2009

722

LC

Timeliness of care

Shorter intervals to diagnosis or treatment

Mixed

15

NS

NS

 

− in 4 studies;

<> in 8 studies;

+ in 3 studies

 Neal, 2015

8441

mxdC (LC)

Timeliness of care

Shorter diagnostic interval: time from first seen in primary care to diagnosis

Mixed

4

122–378

NS

 

<> in 3 studies;

+ in 1 study

 Neal, 2015

8441

mxdC (NSCLC)

Timeliness of care

Shorter treatment interval: time from first seen in primary care to treatment

Retrospective

2

415–495

NS

 

<> in 1 study;

− in 1 study

 Neal, 2015

8441

mxdC (NSCLC)

Timeliness of care

Shorter patient interval: time from symptom onset to first seen in primary

Retrospective

2

122–7358

NS

 

<> in 1 study;

− in 1 study

 Neal, 2015

8441

mxdC (LC)

Timeliness of care

Shorter time from symptom onset to diagnosis

Retrospective

1

NS (total 566)

NS

 

+ in 1 study

 Neal, 2015

8441

mxdC (LC)

Timeliness of care

Shorter time from symptom onset to treatment

Retrospective

1

NS (total 103)

NS

 

<> in 1 study

 Neal, 2015

8441

mxdC (NSCLC)

Timeliness of care

Shorter time from symptom onset to being seen in specialist care

Retrospective

1

NS (total 415)

NS

 

<> in 1 study

Clinical characteristics or routinely assessed biological variables

 Christopoulos, 2013**

5789

LC

TB

Active tuberculosis, TB (vs no TB)

Retrospective

5

NS

Median survival

 

− 1 in study;

? in 4 studies (no comparative data)

 Buttigliero, 2011

494

mxdC LC

VitD level

Low serum vitamin D level

Prospective

2

294–447

HR

 

<> in 2 studies

 Ashworth, 2014**

105

NSCLC (oligometastatic)

Stage

IB (vs IA)

Prospective

20

6–262

HR

<>

 

 Ashworth, 2014**

105

NSCLC (oligometastatic)

Stage

IIA (vs IA)

Prospective

20

6–262

HR

<>

 

 Ashworth, 2014**

105

NSCLC (oligometastatic)

Stage

IIB (vs IA)

Prospective

20

6–262

HR

− (unadj)

 

 Ashworth, 2014**

105

NSCLC (oligometastatic)

Stage

IIIA (vs IA)

Prospective

20

6–262

HR

− (unadj)

 

 Ashworth, 2014**

105

NSCLC (oligometastatic)

Stage

IIIB (vs IA)

Prospective

20

6–262

HR

− (unadj)

 

 Ashworth, 2013**

237

NSCLC (oligometastatic)

Stage

Stage I (vs III or IV)

Mixed

5

NS

NS

 

+ in 1 studies;

<> in 4 studies

 Aboshi, 2014**

182

NSCLC (late)

Stage

Percentage of patients in study with stage IV disease < 80 (vs ≥ 80)

Prospective

13

39–1217

OR

<>

 

 Salah, 2012**

467

NSCLC (solitary met)

Stage

Intra-thoracic stage III (vs stage II or I)

Retrospective

36

NS

HR

−

 

 Deghaidy 2005**

923

LC (NSCLC)

Stage

Stage I vs II (in NSCLC)

Mixed

10

23–226

RR

+

+ in 5 studies;

<> in 5 studies

 Deghaidy 2005**

923

LC (SCLC)

Stage

Stage I vs II (in SCLC)

Mixed

4

24–295

RR

+

+ in 3 studies;

<> in 1 study

 Deghaidy 2005**

923

LC (NSCLC)

Stage

Stage I vs III (in NSCLC)

Mixed

7

33–1342

RR

+

+ in 4 studies;

<> in 3 studies

 Deghaidy 2005**

923

LC (SCLC)

Stage

Stage I vs III (in SCLC)

Mixed

3

27–92

RR

+

+ in 2 studies;

<> in 1 study

 Deghaidy 2005**

923

LC (NSCLC)

Stage

Stage II vs III (in NSCLC)

Mixed

7

57–961

RR

+

+ in 3 studies;

<> in 4 studies

 Deghaidy 2005**

923

LC (SCLC)

Stage

Stage II vs III (in SCLC)

Mixed

3

25–95

RR

+

<> in 3 studies

 Deghaidy 2005**

923

LC (NSCLC)

Stage

Stage III vs IV (in NSCLC)

Mixed

6

21–2198

RR

+

+ in 3 studies;

<> in 3 studies

 Deghaidy 2005**

923

LC (SCLC)

Stage

Stage III vs IV (in SCLC)

Mixed

2

22–319

RR

<>

<> in 2 studies

 Carter, 2014

5362

NSCLC (III–IV)

Stage

Less advanced stage, mainly IIIB (vs IV)

Retrospective

37

NS

NS

 

+ in 21 studies;

<> in 16 studies

 Behera, 2016**

5815

NSCLC (I)

Stage

Adenocarcinoma in situ, AIS (vs minimally invasive adenocarcinoma, MIA)

NS

11

8–110

Survival rate

<>

 

 Berghmans, 2011

8434

NSCLC (III)

Stage

Less advanced stage

NS

NS

NS

NS

 

+ in 6 studies;

<> NS

 Brundage, 2002

1051

NSCLC (early)

Stage

Less advanced stage

NS

103

31–593

NS

 

+ in 68 studies;

<> in 35 studies

 Berghmans, 2011

8434

NSCLC (III)

T volume

Tumour volume

NS

NS

NS

NS

 

+ in 2 studies;

<> NS

 Yu, 2015**

5489

NSCLC (unresectable)

GTV

Small gross tumour volume, GTV < 112 cm3vs (vs large GTV >= 112cm3)

NS

5

32–115

HR

+

 

Prognostic factors classified as ‘other’

 Ashworth, 2014

105

NSCLC (oligometastatic)

Surgical treatment

Surgical primary LC treatment (vs non-surgical)

Prospective

20

6–262

HR

+ (unadj)

 

 Ashworth, 2013

237

NSCLC (oligometastatic)

Surgery

Type of thoracic resection: lobectomy (vs pneumonectomy)

Mixed

2

NS

NS

 

+ in 1 studies;

<> in 1 studies

 Berghmans, 2011

8434

NSCLC (III)

Surgery

R0 (complete resection)

NS

NS

NS

NS

 

+ in 4 studies;

<> NS

 Brundage, 2002

1051

NSCLC (early)

Surgery

Surgical procedure (no further details)

NS

15

43–593

NS

 

+ in 4 studies;

<> in 11 studies

  1. *Three reviews which evaluated ‘any’ prognostic factor included a minimum of 50 factors: Ashworth, 2013 (237); Berghmans, 2011 (8434); and Brundage, 2002 (1051). Beghmans, 2011, (which included 39 studies) provided a list of factors found to be significant in multivariate analysis, but did not indicate the number of studies that had evaluated each factor; the description of each factor was also minimal. For Berghmans, 2011 (8434), only factors found to be significant by included studies (reporting multivariate analysis) were listed with minimal descriptors; the total number of studies which evaluated each factor was not reported. Brundage, 2002 (1051), included separate analysis for studies that investigated prognostic factors in resected NSCLC. The description of the prognostic factors were minimal and are reported verbatim here (not stated what the comparator was)
  2. **The actual results for these studies are presented in Additional file 8 (Appendix H)
  3. ***Narrative synthesis reported by the review
  4. REV ID review unique identification number, BMI body mass index, GTV gross tumour volume, HR hazard ratio, LC lung cancer, MR-meta regression, MDT multidisciplinary team, mxdC mixed cancer, NS not stated, NSCLC non-small cell lung cancer, OR odds ratio, PS performance status, RR relative risk, SCLC small cell lung cancer, TB tuberculosis, vs versus
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Systematic Reviews

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