Prognostic value of the StAN score in elderly small cell lung cancer

Abstract Lung cancer, the leading cause of cancer-related mortality, includes small-cell lung cancer (SCLC), which accounts for 15% of cases. The median age of lung cancer diagnosis is 71, highlighting the need for accessible prognostic tools in elderly patients. The prognostic nutritional index (PN...

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Main Authors: Feride Yılmaz, Serkan Yaşar, Ömer Denizhan Tatar, Hasan Çağrı Yıldırım, Denizcan Güven, Burak Yasin Aktaş, Hakan Taban, Zafer Arık, Mustafa Erman
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Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-08115-x
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author Feride Yılmaz
Serkan Yaşar
Ömer Denizhan Tatar
Hasan Çağrı Yıldırım
Denizcan Güven
Burak Yasin Aktaş
Hakan Taban
Zafer Arık
Mustafa Erman
author_facet Feride Yılmaz
Serkan Yaşar
Ömer Denizhan Tatar
Hasan Çağrı Yıldırım
Denizcan Güven
Burak Yasin Aktaş
Hakan Taban
Zafer Arık
Mustafa Erman
author_sort Feride Yılmaz
collection DOAJ
description Abstract Lung cancer, the leading cause of cancer-related mortality, includes small-cell lung cancer (SCLC), which accounts for 15% of cases. The median age of lung cancer diagnosis is 71, highlighting the need for accessible prognostic tools in elderly patients. The prognostic nutritional index (PNI) has shown promise in predicting survival in various cancers. This study evaluates the performance of a PNI-based novel scoring system in elderly SCLC patients. We analyzed 117 patients aged ≥ 65 diagnosed with SCLC between 2007 and 2023. Data on age, Eastern Cooperative Oncology Group Scale (ECOG) performance status, hemoglobin levels, disease stage, and PNI were collected. The StAN score, incorporating stage (extensive vs. limited), hemoglobin (normal vs. low), and PNI (< median vs. ≥ median), was derived from multivariate analyses. Patients were classified into low- and high-risk categories. Kaplan-Meier and Cox models assessed overall survival (OS) and progression-free survival (PFS). The median age was 71 years, with 89.7% male patients. Median follow-up was 12.4 months. Patients with low PNI had shorter OS (7.6 vs. 18.2 months, p < 0.001) and PFS (5.4 vs. 10.3 months, p < 0.001). High-risk patients, based on the StAN score, had shorter OS (7.8 vs. 18.5 months, HR 2.38, p < 0.001) and PFS (5.4 vs. 10.3 months, HR 2.29, p < 0.001). Harrell’s C indices for predicting OS and PFS were 0.72 and 0.73, respectively. In conclusion, the StAN score is a reliable prognostic tool for elderly SCLC patients and may help stratify patients and improve treatment strategies.
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spelling doaj-art-c6c85b217f82460dba1a584ca80b787e2025-08-20T03:38:16ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-08115-xPrognostic value of the StAN score in elderly small cell lung cancerFeride Yılmaz0Serkan Yaşar1Ömer Denizhan Tatar2Hasan Çağrı Yıldırım3Denizcan Güven4Burak Yasin Aktaş5Hakan Taban6Zafer Arık7Mustafa Erman8Department of Medical Oncology, Samsun Education and Research HospitalDepartment of Medical Oncology, Abdurrahman Yurtaslan Oncology Education and Research HospitalDepartment of Internal Medicine, Türkeli State HospitalDepartment of Medical Oncology, Niğde Education and Research HospitalDepartment of Medical Oncology, Hacettepe University Cancer InstituteDepartment of Medical Oncology, Hacettepe University Cancer InstituteDepartment of Medical Oncology, Ankara Medical Park HospitalDepartment of Medical Oncology, Hacettepe University Cancer InstituteDepartment of Medical Oncology, Hacettepe University Cancer InstituteAbstract Lung cancer, the leading cause of cancer-related mortality, includes small-cell lung cancer (SCLC), which accounts for 15% of cases. The median age of lung cancer diagnosis is 71, highlighting the need for accessible prognostic tools in elderly patients. The prognostic nutritional index (PNI) has shown promise in predicting survival in various cancers. This study evaluates the performance of a PNI-based novel scoring system in elderly SCLC patients. We analyzed 117 patients aged ≥ 65 diagnosed with SCLC between 2007 and 2023. Data on age, Eastern Cooperative Oncology Group Scale (ECOG) performance status, hemoglobin levels, disease stage, and PNI were collected. The StAN score, incorporating stage (extensive vs. limited), hemoglobin (normal vs. low), and PNI (< median vs. ≥ median), was derived from multivariate analyses. Patients were classified into low- and high-risk categories. Kaplan-Meier and Cox models assessed overall survival (OS) and progression-free survival (PFS). The median age was 71 years, with 89.7% male patients. Median follow-up was 12.4 months. Patients with low PNI had shorter OS (7.6 vs. 18.2 months, p < 0.001) and PFS (5.4 vs. 10.3 months, p < 0.001). High-risk patients, based on the StAN score, had shorter OS (7.8 vs. 18.5 months, HR 2.38, p < 0.001) and PFS (5.4 vs. 10.3 months, HR 2.29, p < 0.001). Harrell’s C indices for predicting OS and PFS were 0.72 and 0.73, respectively. In conclusion, the StAN score is a reliable prognostic tool for elderly SCLC patients and may help stratify patients and improve treatment strategies.https://doi.org/10.1038/s41598-025-08115-xSmall-cell lung cancerNutritionElderly patientsPrognosisSurvivalPrognostic model
spellingShingle Feride Yılmaz
Serkan Yaşar
Ömer Denizhan Tatar
Hasan Çağrı Yıldırım
Denizcan Güven
Burak Yasin Aktaş
Hakan Taban
Zafer Arık
Mustafa Erman
Prognostic value of the StAN score in elderly small cell lung cancer
Scientific Reports
Small-cell lung cancer
Nutrition
Elderly patients
Prognosis
Survival
Prognostic model
title Prognostic value of the StAN score in elderly small cell lung cancer
title_full Prognostic value of the StAN score in elderly small cell lung cancer
title_fullStr Prognostic value of the StAN score in elderly small cell lung cancer
title_full_unstemmed Prognostic value of the StAN score in elderly small cell lung cancer
title_short Prognostic value of the StAN score in elderly small cell lung cancer
title_sort prognostic value of the stan score in elderly small cell lung cancer
topic Small-cell lung cancer
Nutrition
Elderly patients
Prognosis
Survival
Prognostic model
url https://doi.org/10.1038/s41598-025-08115-x
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