Survival in a cohort of patients with lung cancer: the role of age and gender in prognosis

Abstract

Objective:To determine the demographic and clinical characteristics of patients with non-small cell lung cancer (NSCLC), as well as their disease course, by age group and gender. Methods:This was a retrospective cohort study of patients diagnosed with NSCLC from 2000 to 2012 and followed until July 2015 in a tertiary referral hospital in the city of São Paulo, Brazil. Based on the 25th and 75th percentiles of the age distribution, patients were stratified into three age groups: < 55 years; ≥ 55 and < 72 years; and ≥ 72 years. Survival time was evaluated during the follow-up period of the study. Functions of overall and gender-specific survival stratified by age groups (event: all-cause mortality) were calculated using the Kaplan-Meier method. Differences among survival curves were assessed via the log-rank test. Results:We included 790 patients with the following age distribution: < 55 years, 165 patients; ≥ 55 and < 72 years, 423; and ≥ 72 years, 202. In the entire sample, there were 493 men (62.4%). Adenocarcinoma was the most common histological pattern in the < 72-year age groups; 575 patients (73%) presented with advanced disease (stages IIIB-IV). The median 5-year survival was 12 months (95% CI: 4-46 months), with no significant differences among the age groups studied. Conclusions:NSCLC remains more common in men, although we found an increase in the proportion of the disease in women in the < 55-year age group. Adenocarcinoma predominated in women. In men, squamous cell carcinoma predominated in the ≥ 72-year age group. Most patients presented with advanced-stage disease at diagnosis. There were no statistical differences in survival between genders or among age groups.

Distinct Prognostic Factors in Patients with Stage I Non–Small Cell Lung Cancer with Radiologic Part-Solid or Solid Lesions

“…As for age, there seem to be controversies in previous studies, with some researchers believing that old age is associated with worse survival 27,28 and others not believing this. 29,30 In our study, we also found that old age was associated with worse survival in only the solid group (p ¼ 0.030) and not in the part-solid group (p ¼ 0.993). Moreover, consistent with previous studies, 31,32 our study demonstrated that pathological tumor size is a significant risk factor in both the solid and part-solid groups.…”

Analysis of Expression and Its Clinical Significance of the Secreted Phosphoprotein 1 in Lung Adenocarcinoma

“…Approximately 75% of patients are diagnosed with metastatic or advanced cancer and often lose the opportunity for radical surgery. With the improvements of modern clinical diagnostic methods, the survival rate is still unsatisfactory, only ∼15%, although the overall survival rate and the quality of life have been improved (Siegel et al, 2015;Franceschini et al, 2017). In recent years, in addition to improving the treatment of lung cancer patients, searching for effective tumor markers to guide clinical diagnosis has become a hot spot in LUAD research.…”

Evolution in the management of non-small cell lung cancer in Brazil

“…Another relevant aspect reported by Franceschini et al 15 concerns mortality. No differences regarding mortality were found in the different age groups evaluated.…”

“…In the present issue of JBP, Franceschini et al 15 provide relevant information on the epidemiology of patients with NSCLC in Brazil. In their retrospective cohort involving 790 patients from a tertiary center in the city of São Paulo, Brazil, who were followed between 2000 and 2012, the distribution of patients with NSCLC was heterogeneous: in younger patients (< 72 years of age) and in women, the predominant histological type was adenocarcinoma.…”