Twenty-four-hour urinary cortisol levels before complete resection of non-small cell lung cancer and survival

Figures & data

Table I.  Characteristics of the subjects according to twenty-four-hour urinary cortisol levels.

	Twenty-four-hour urinary cortisol levels (µg/day)*			p value
Characteristics	≤17.7	17.8–29.3	≥29.4	ANOVA or χ^2 test
No. of subjects	75	75	76
Demographic data
Age in years, mean±SD	63.0±9.2	64.1±11.3	61.3±11.0	0.26
Sex, man, %	50.7	64.0	71.1	0.033
Body mass index in kg/m^2≥25.0, %	13.3	21.3	18.4	0.60
Education, college/university or higher, %	17.3	14.7	26.3	0.17
Marital status, living with spouse, %	82.7	76.0	84.2	0.39
Past histories, %
Myocardial infarction	2.7	4.0	2.6	0.86
Hypertension	22.7	34.7	26.3	0.24
Diabetes mellitus	4.0	8.0	7.9	0.53
Smoking status, %				0.98
Current smoker	40.0	41.3	43.4
Ex-smoker	24.0	26.7	23.7
Never-smoker	36.0	32.0	32.9
History of depression, %§	10.7	10.7	10.5	0.83
Medical data
Pathologic stage, %†
IA	52.0	48.0	50.0	0.68
IB	28.0	22.7	21.1
IIA	2.7	4.0	5.3
IIB	13.3	21.3	15.8
IIIA	4.0	4.0	7.9
Histology, %				0.69
Adenocarcinoma	64.0	66.7	67.1
Squamous carcinoma	26.7	24.0	17.1
Large	4.0	2.7	6.6
Other	5.3	6.7	9.2
Type of surgery				0.16
Lobectomy	98.7	92.0	94.7
Pneumonectomy	1.3	8.0	5.3
Performance status before curative resection, %‡
0	66.7	69.3	69.7
1	33.3	30.3	30.3
Serum albumin in g/100 ml ≥ 3.5, %	8.0	9.3	5.3	0.63

*The 24-h urinary cortisol levels were divided into three categories in manner such that the total subjects grouped as closely as possible into even-sized tertiles.

†Defined by TNM classification: International Union Againt Cancer.

‡Defined by the Eastern Cooperlative Oncology Group.

§Defined by the Structured Clinical Interview for DSM-III-R (SCID).

Table II.  Results of Cox's proportional-hazards regression analysis for pathologic stage and survival from lung cancer*.

	Pathologic stage
	IA	IB	IIA–IIB	IIIA
No. of subjects	113	54	47	12
Median follow-up time (range), months	74 (9–91)	68 (11–97)	66 (1–89)	38 (3–87)
No. of deaths from all causes	17	10	22	7
Sex-, age-adjusted RR1	1.00 (referent)	1.05 (0.48-2.33)	3.22 (1.70–6.11)	4.98 (2.02–12.26)
Multivariable adjusted RR1	1.00 (referent)	0.77 (0.33-1.79)	2.91 (1.34–6.31)	2.89 (0.95–8.78)

*The multivariate relative risk (RR) has been adjusted for age (continuous variables); sex; body mass index in kg/m2 (<18.4, 18.5–24.9, or >25.0); education (college/university or higher or other); marital status (living with spouse or other); past histories (myocardial infarction, hypertension, or diabetes mellitus); cigarette smoking (never smoked, smoked in the past, or currently smoking); history of depression (presence or absence); histology (adenocarcinoma, squamous carcinoma, large, or other); type of surgery (lobectomy or pneumonectomy); performance status before curative resection (0 or 1); serum albumin levels in g/100 ml (<3.4 or >3.5); 24-h urinary cortisol levels in µg/day (<17.7, 17.8–29.3, or >29.4). RR1 denotes the RR with all cases of deaths.

Table III.  Results of Cox's proportional-hazards regression analysis for twenty-four-hour urinary cortisol levels and survival from lung cancer*.

	Twenty-four-hour urinary cortisol levels (µg/day)
	≤17.7	17.8–29.3	≥29.4	p for linear trend
No. of subjects	75	75	76
Median follow-up time (range), months	71 (11–89)	71 (5–90)	72 (1–97)
No. of deaths from all causes	17	22	17
Sex-, age-adjusted RR1	1.00 (referent)	1.17 (0.62–2.22)	0.87 (0.44–1.71)	0.58
Multivariable adjusted RR1	1.00 (referent)	1.09 (0.54–2.21)	1.17 (0.55–2.46)	0.17
Multivariable adjusted RR2	1.00 (referent)	0.76 (0.34–1.73)	1.00 (0.45–2.22)	0.75

*The multivariate relative risk (RR) has been adjusted for age (continuous variables); sex; body mass index in kg/m2 (<18.4, 18.5–24.9, or >25.0); education (college/university or higher or other); marital status (living with spouse or other); past histories (myocardial infarction, hypertension, or diabetes mellitus); cigarette smoking (never smoked, smoked in the past, or currently smoking); history of depression (presence or absence); pathologic stage (IA, IB, IIA-IIB, or IIIA); histology (adenocarcinoma, squamous carcinoma, large, or other); type of surgery (lobectomy or pneumonectomy); performance status before curative resection (0 or 1); serum albumin levels in g/100 ml (<3.4 or >3.5). RR1 denotes the RR with all cases of deaths. RR2 denotes the RR with cases of death who died in the first 1 year of follow-up excluded from the analysis.

Table IV.  Results of Cox's proportional-hazards regression analysis for twenty-four-hour urinary cortisol levels and survival from lung cancer according to pathologic stage*.

	Twenty-four-hour urinary cortisol levels (µg/day)
	≤17.7	17.8–29.3	≥29.4	p for linear trend
	Pathologic stage IA (n = 113)
No. of subjects	39	36	38
Median follow-up time (range), months	73 (29–83)	75 (21–89)	80 (9–91)
No. of deaths from all causes	17	22	17
Multivariable adjusted RR1	1.00 (referent)	1.91 (0.38–9.77)	0.81 (0.16–4.10)	0.41
	Pathologic stage IB to IIIA (n = 113)
No. of subjects	36	39	38
Median follow-up time (range), months	66 (11–89)	65 (5–90)	67 (1–97)
No. of deaths from all causes	17	22	17
Multivariable adjusted RR1	1.00 (referent)	1.20 (0.50–2.88)	1.05 (0.42–2.62)	0.09

*The multivariate relative risk (RR) has been adjusted for age (continuous variables); sex; body mass index in kg/m2 (<18.4, 18.5–24.9, or >25.0); education (college/university or higher or other); marital status (living with spouse or other); past histories (myocardial infarction, hypertension, or diabetes mellitus); cigarette smoking (never smoked, smoked in the past, or currently smoking); history of depression (presence or absence); histology (adenocarcinoma, squamous carcinoma, large, or other); type of surgery (lobectomy or pneumonectomy); performance status before curative resection (0 or 1); serum albumin levels in g/100 ml (<3.4 or >3.5). RR1 denotes the RR with all cases of deaths.