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Survival in Patients with Lung CancerAn Appraisal of Feinstein's Symptom Classification
MAJ Robert M. Senior, MC;
CPT James S. Adamson, MC
Arch Intern Med. 1970;125(6):975-980.
Abstract
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Feinstein has proposed a system for classifying patients with lung cancer according to their symptoms at diagnosis. He observed a gradient of survival between the different symptom stages. We have applied Feinstein's classification to 646 patients with cancer of the lung. It was observed that survival was highest in the patients who were asymptomatic at the time of diagnosis. Patients with protracted local symptoms before diagnosis had a higher survival rate than patients whose symptoms were systemic or pulmonary but of short duration. Patients with metastatic symptoms at the time of cancer detection had the lowest survival rate. These differences in survival relative to symptoms at diagnosis persisted even after the patients were divided into groups having similar extents of tumor spread. The present observations confirm the occurrence of patterns of survival which correspond to symptom stages and therefore support the concept, advanced by Feinstein, that symptoms in lung cancer have prognostic significance.
Author Affiliations
USAR; USAR, Washington, DC
From the Pulmonary and Communicable Disease Service, Department of Medicine, Walter Reed General Hospital, Washington, DC. Dr. Senior is now with Washington University School of Medi-; cine and Jewish Hospital of St Louis. Dr. Adamson is now with the University of Arkansas Medical Center and the Veterans Administration Hospital, Little Rock.
Footnotes
Received for publication Sept 24, 1969; accepted Dec 22.
Reprint requests to 216 S Kingshighway, St. Louis 63110 (Dr. Senior).
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