Prospective population-based study on the survival of patients with lung cancer

Abstract

Prospective population-based study on the survival of patients with lung cancer. R. Mäkitaro, P. Pääkko, E. Huhti, R. Bloigu, V.L. Kinnula. #ERS Journals Ltd 2002. ABSTRACT: The purpose of this study was to evaluate the change, over 20 yrs, in the survival of lung cancer patients in a population-based study.Information on all patients with lung cancer in a defined geographical area during 1990-1992 (n=602) was prospectively gathered. The survival of these patients was assessed and also compared with the results of a similar study in the same area during the years 1968-1971 (n=446).The 5-yr survival had improved during 20 yrs from 4% to 12%. The 5-yr survival of the patients with squamous cell carcinoma had increased from 6% to 16%, and adenocarcinoma from 4% to 19%, whereas the survival of small cell carcinoma had remained the same (2% and 3%, respectively). Even though the recent patients were older than those of the earlier series the proportion of surgically treated patients had remained the same (16% and 20%), but the 5-yr survival of patients who had been operated on had increased significantly from 23% to 48%. The differences in survival in the second cohort (1990)(1991)(1992) between histological types (Chi-squared logrank=59.2), tumour, node, metastasis stages (Chi-squared logrank=199.6), symptomatic stages (Chi-squared logrank=120, pv0.001) and treatment (Chi-squared logrank=277) were significant.Based on this study the independent prognostic factors for better survival of lung cancer patients are tumour, node, metastasis stages I and II, surgical treatment and Feinstein9s symptomatic stages I and II.

Lung cancer survival in Spain and prognostic factors: A prospective, multiregional study

“…Still, a high percentage (29.8%) of our lung cancer patients received palliative treatment only. Similarly high percentages were observed in other studies: 25% of the series of lung cancer patients in Varese [5], 50% of the patients in Teesside [5], and 36% of patients in a Finnish study [3].…”

“…There were therefore probably no false positive cases, although we believe that some patients with true lung cancer might have been excluded. The percentage of histologically ascertained cases (92.8%) was higher than in other comprehensive studies [3][4][5]15], probably due to our strict inclusion criteria. In any case, the average crude incidence rates for men (84.3/100,000) and women (9.4/100,000) were similar or slightly higher than previously registered in some areas of the participating centers [8][9][10][11].…”

“…More advanced disease at diagnosis, the absence of thoracic surgery and the small size of some hospitals could explain lower resection rates. The average resection rate of 14.9% for the population overall was higher than or similar to that reported in other European countries [3][4][5]15], but it was lower than rates previously registered in some of the participant centers [8,17]. In the current study, 71.4% of patients undergoing surgery had clinical TNM stage I, and the average perioperative mortality, 4.8%, was lower than previously observed by a Spanish bronchogenic carcinoma cooperative group, 6.6% [18].…”

“…However, few studies have focussed on the management of elderly patients and their survival, and some recent papers on the overall management of lung cancer show a high proportion of such patients receiving only palliative treatment [3][4][5][6][7]. The rising proportion of elderly patients and their high rate of comorbidity probably influence treatment approaches.…”

Clinical significance of preoperative carcinoembryonic antigen level in patients with clinical stage IA non-small cell lung cancer

“…More than 60% of patients with lung cancer present with stage IIIB/IV disease, and late diagnosis is common (2). The increased frequency of detecting stage IA non-small cell lung cancer (NSCLC) in Japan can be attributed to a nationwide mass screening system, and surgery for patients with early-stage small-sized NSCLC is being performed more often (3).…”