Non-small-cell lung cancer in a French department, (1982–1997): management and outcome

Abstract

Addition of chemotherapy to the treatment of non-small-cell lung cancer (NSCLC) resulted in a modest but clear improvement in the survival of selected patients. To ascertain if this translates to improved survival in the whole population of patients, we conducted a retrospective population-based study of a sample of 1738 patients diagnosed with primary NSCLC in a French department between 1982 and 1997. The proportion of women, metastatic cases and adenocarcinoma changed significantly over time, as did their management: use of chemotherapy alone increased from 9.7 to 28.1% (Po0.0001), while the use of radiotherapy alone decreased from 32.2 to 9.4% (Po0.0001). The 5-year survival probability was 15.7 % for all patients and 32.6% for those with resectable disease. The 1-and 2-year survival probabilities were 38.2 and 15.6% in locally advanced disease, and were, respectively, 16.8 and 5.2% in metastatic disease. Disease extent and histological subtype were significant independent prognostic factors. Survival of resectable disease was longer among patients treated with surgery or surgery plus chemotherapy, while better outcomes for locally advanced disease were associated with radiation plus chemotherapy. In metastastic disease, patients treated by classical agent without platin or palliative care only had the shortest survival. Despite changes in treatment in accordance with the state-of-the-art, overall survival did not improve over time. It is not unlikely that more patients with bad PS were diagnosed during the latter end of the study period. This could at least partially explain the absence of detection of an overall improvement in survival.

Gender-Related Survival in Different Stages of Lung Cancer—A Population Study over 20 Years

“…This has been previously reported by Albain et al [25]. In later studies, there were no differences in outcome in patients younger than age < 70 compared to those who were at least 70 years old [26].…”

New Aspects in the Epidemiology of Lung Cancer — The Women’s Epidemic

“…Age at diagnosis has been considered as higher in females in some studies, 11,47 whereas in other studies authors report a lower age. 9 These discrepancies might be due to the proportion of non-smokers in these series.…”

“…Even if the incidence of lung cancer in male non-smokers is consistently higher than in female non-smokers, 8 the proportion of non-smokers in females with lung cancer is rather significant compared with males in all studies. [9][10][11] Higher Tobacco-smoke Susceptibility in Females Some case-control studies suggest a higher susceptibility to tobacco for females. A 1993 analysis found an odds ratio of 27.9 (95% confidence interval (CI) 14.9-52) for women who have smoked 40 pack-years (one pack a day for 40 years or two packs a day for 20 years, etc.)…”

Survie des patients atteints de cancer en France: principaux résultats de la première étude du réseau des registres français des cancers (Francim)

“…Pour l'Europe, il est habituel de considé rer comme é tude de ré fé rence le projet Eurocare [3], qui tient à jour une base de donné es de plus de six millions de cas de cancers diagnostiqué s depuis 1979 dans 22 pays europé ens. Pour la France, un certain nombre d'é tudes ont é té publié es [5,6,9] -ré fé rences non exhaustives -sans jamais regrouper l'ensemble des donné es disponibles au sein du ré seau Francim.…”