Palliative chemotherapy does not improve survival in metastatic XXXX .

@entity1 @entity5 @entity957 @entity418 @entity1282
BACKGROUND: The role of chemotherapy in @entity418 ( @entity418 ) remains a matter of debate. The aim of this retrospective study was to analyze the survival impact of chemotherapy after stratification for prognostic factors. METHODS: Consecutive @entity1 with @entity418 (1995 to 2008) were randomly assigned to a development (n = 171) and a validation cohort (n = 113). We had first identified prognostic factors using the Kaplan-Meier and Cox methods in the development cohort and then validated them in the validation cohort. Then, we analyzed the impact of chemotherapy after stratification for these prognostic factors. The majority of @entity1 had @entity957 (80%). RESULTS: The Cox model has retained 2 prognostic factors only: associated @entity5 (hazard ratio = 2.77, range 1.39-5.54, p = 0.004) and grade 3-4 @entity1282 (hazard ratio = 1.44, range 1.08-2.14, p = 0.007). Median survival was 10.9 in @entity1 with 0 (n = 77), 6.2 in those with 1 (n = 65) and 1.8 months in those with 2 prognostic factors (n = 11/171; p = 0.025). The median survival times of the @entity1 with 0, 1 and 2 prognostic factors were 13 versus 9 months (nonsignificant, NS), 6 versus 5 months (NS) and 5 versus 1.3 months (NS) in @entity1 with and without chemotherapy, respectively. CONCLUSION: Our data suggest that chemotherapy has no significant effect on survival for unselected @entity418 @entity1 , regardless of the prognostic factors we identified.
