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Thamrongjirapat T, Muntham D, Incharoen P, Trachu N, Sae-Lim P, Sarachai N, Khiewngam K, Monnamo N, Kantathut N, Ngodngamthaweesuk M, Ativitavas T, Chansriwong P, Nitiwarangkul C, Ruangkanchanasetr R, Kositwattanarerk A, Sirachainan E, Dejthevaporn T, Reungwetwattana T. Molecular alterations and clinical prognostic factors in resectable non-small cell lung cancer. BMC Cancer 2024; 24:200. [PMID: 38347487 PMCID: PMC10863204 DOI: 10.1186/s12885-024-11934-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND EGFR inhibitor and immunotherapy have been approved for adjuvant treatment in resectable non-small cell lung cancer (NSCLC). Limited reports of molecular and clinical characteristics as prognostic factors in NSCLC have been published. METHODS Medical records of patients with resectable NSCLC stage I-III diagnosed during 2015-2020 were reviewed. Real time-PCR (RT-PCR) was performed for EGFR mutations (EGFRm). Immunohistochemistry staining was conducted for ALK and PD-L1 expression. Categorical variables were compared using chi-square test and Fisher's exact test. Survival analysis was done by cox-regression method. RESULTS Total 441 patients were included. The prevalence of EGFRm, ALK fusion, and PD-L1 expression were 57.8%, 1.9%, and 20.5% (SP263), respectively. The most common EGFRm were Del19 (43%) and L858R (41%). There was no significant difference of recurrence free survival (RFS) by EGFRm status whereas patients with PD-L1 expression (PD-L1 positive patients) had lower RFS compared to without PD-L1 expression (PD-L1 negative patients) (HR = 1.75, P = 0.036). Patients with both EGFRm and PD-L1 expression had worse RFS compared with EGFRm and PD-L1 negative patients (HR = 3.38, P = 0.001). Multivariable analysis showed higher CEA at cut-off 3.8 ng/ml, pT4, pN2, pStage II, and margin were significant poor prognostic factors for RFS in the overall population, which was similar to EGFRm population (exception of pT and pStage). Only pStage was a significant poor prognostic factor for PD-L1 positive patients. The predictive score for predicting of recurrence were 6 for all population (63% sensitivity and 86% specificity) and 5 for EGFRm population (62% sensitivity and 93% specificity). CONCLUSION The prevalence and types of EGFRm were similar between early stage and advanced stage NSCLC. While lower prevalence of PD-L1 expression was found in early stage disease. Patients with both EGFRm and PD-L1 expression had poorer outcome. Thus PD-L1 expression would be one of the prognostic factor in EGFRm patients. Validation of the predictive score should be performed in a larger cohort.
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Affiliation(s)
- T Thamrongjirapat
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - D Muntham
- Department of Mathematics, Faculty of Science and Technology, Rajamangala University of Technology Suvarnabhumi, Bangkok, Thailand
| | - P Incharoen
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - N Trachu
- Research Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - P Sae-Lim
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - N Sarachai
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - K Khiewngam
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - N Monnamo
- Research Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - N Kantathut
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - M Ngodngamthaweesuk
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - T Ativitavas
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - P Chansriwong
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - C Nitiwarangkul
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - R Ruangkanchanasetr
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Radiation and Oncology Unit, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - A Kositwattanarerk
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Division of Nuclear Medicine, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - E Sirachainan
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - T Dejthevaporn
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - T Reungwetwattana
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
- Ramathibodi Lung Cancer Consortium (RLC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Désage AL, Tissot C, Bayle-Bleuez S, Muron T, Deygas N, Grangeon-Vincent V, Monange B, Torche F, Vercherin P, Kaczmarek D, Tiffet O, Forest F, Vergnon JM, Bouleftour W, Fournel P. Adjuvant chemotherapy for completely resected IIA-IIIA non-small cell lung cancer: compliance to guidelines, safety and efficacy in real-life practice. Transl Lung Cancer Res 2022; 11:2418-2437. [PMID: 36636405 PMCID: PMC9830267 DOI: 10.21037/tlcr-22-345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/23/2022] [Indexed: 12/27/2022]
Abstract
Background Since randomised clinical trials demonstrated a survival benefit of adjuvant chemotherapy (AC) following curative-intent lung surgery, AC has been implemented as a standard therapeutic strategy for patients with a completely resected IIA-IIIA non-small cell lung cancer (NSCLC). Regarding the moderate benefit of AC and the lack of literature on AC use in real-life practice, we aimed to evaluate compliance to guidelines, AC safety and efficacy in a less selected population. Methods Between January 2009 and December 2014, we retrospectively analysed 210 patients with theoretical indication of AC following curative-intent lung surgery for a completely resected IIA-IIIA NSCLC. The primary objective of this retrospective study was to evaluate compliance to AC guidelines. Secondary objectives included safety and efficacy of AC in real-life practice. Results Among 210 patients with a theoretical indication of AC, chemotherapy administration was validated in multidisciplinary team (MDT) for 62.4% of them and 117 patients (55.7%) finally received AC. Patient's clinical conditions were the main reasons advanced in MDT for no respect to AC guidelines. Most of the patients received cisplatin-vinorelbine (86.3%) and AC was initiated within 8 weeks following lung surgery for 73.5% of patients. One-half of patients who received AC experienced side effects leading to either dose-intensity modification or treatment interruption. In real-life practice, AC was found to provide a survival benefit over surgery alone. Factors related to daily-life practice such as delayed AC initiation or incomplete AC planned dose received were not associated with an inferior survival. Conclusions Although AC use might differ from guidelines in real-life practice, this retrospective study highlights that AC can be used safely and remains efficient among a less selected population. In the context of immunotherapy and targeted therapies development in peri-operative treatment strategies, the place of AC has to be precised in the future.
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Affiliation(s)
- Anne-Laure Désage
- Department of Pulmonology and Thoracic Oncology, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Claire Tissot
- Oncology Department, Private Loire Hospital (HPL), Saint-Etienne, France
| | - Sophie Bayle-Bleuez
- Department of Pulmonology and Thoracic Oncology, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Thierry Muron
- Oncology Department, Private Loire Hospital (HPL), Saint-Etienne, France.,Department of Medical Oncology, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Nadine Deygas
- Department of Pulmonology, Gier Hospital, Saint-Chamond, France
| | | | - Brigitte Monange
- Department of Medical Oncology, Emile Roux Hospital, Le Puy-en-Velay, France
| | - Fatah Torche
- Department of Medical Oncology, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Paul Vercherin
- Public Health and Medical Informatics Department, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - David Kaczmarek
- Thoracic and Digestive Surgery Department, Private Loire Hospital (HPL), Saint-Etienne, France
| | - Olivier Tiffet
- Department of Thoracic Surgery, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Fabien Forest
- Pathology Department, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Jean-Michel Vergnon
- Department of Pulmonology and Thoracic Oncology, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Wafa Bouleftour
- Department of Medical Oncology, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Pierre Fournel
- Department of Medical Oncology, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
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Wu YL, John T, Grohe C, Majem M, Goldman JW, Kim SW, Kato T, Laktionov K, Vu HV, Wang Z, Lu S, Lee KY, Akewanlop C, Yu CJ, de Marinis F, Bonanno L, Domine M, Shepherd FA, Zeng L, Atasoy A, Herbst RS, Tsuboi M. Postoperative Chemotherapy Use and Outcomes From ADAURA: Osimertinib as Adjuvant Therapy for Resected EGFR-Mutated NSCLC. J Thorac Oncol 2021; 17:423-433. [PMID: 34740861 DOI: 10.1016/j.jtho.2021.10.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/14/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Adjuvant chemotherapy is recommended in patients with resected stage IIꟷIIIA (and select IB) NSCLC; however, recurrence rates are high. In the phase III, ADAURA study (NCT02511106), osimertinib demonstrated a highly statistically significant improvement in disease-free survival (DFS) in patients with resected stage IBꟷIIIA EGFRm NSCLC. Here, we report prespecified and exploratory analyses of adjuvant chemotherapy use and outcomes from ADAURA. METHODS Patients with resected stage IBꟷIIIA EGFRm NSCLC were randomized 1:1 to receive osimertinib or placebo for 3 years. Adjuvant chemotherapy before randomization was not mandatory, per physician and patient choice. DFS in the overall population (IBꟷIIIA), with/without adjuvant chemotherapy, was a prespecified analysis. Exploratory analyses included: adjuvant chemotherapy use by patient age, disease stage and geographical location; DFS by adjuvant chemotherapy use and disease stage. RESULTS Overall, 410/682 patients (60%) received adjuvant chemotherapy (osimertinib, n = 203; placebo, n = 207) for a median duration of 4.0 cycles. Adjuvant chemotherapy use was more frequent in patients: aged <70 years (338/509; 66%) versus ≥70 years (72/173; 42%); with stage II-IIIA disease (352/466; 76%) versus stage IB (57/216; 26%); enrolled in Asia (268/414; 65%) versus outside of Asia (142/268; 53%). A DFS benefit favoring osimertinib versus placebo was observed in patients with (DFS HR = 0.16, 95% CI: 0.10ꟷ0.26) and without adjuvant chemotherapy (HR = 0.23, 95% CI: 0.13ꟷ0.40), regardless of disease stage. CONCLUSIONS These findings support adjuvant osimertinib as an effective treatment for patients with stage IB-IIIA EGFRm NSCLC after resection, with or without prior adjuvant chemotherapy.
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Affiliation(s)
- Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
| | - Thomas John
- Department of Medical Oncology, Austin Health, Melbourne, Australia
| | - Christian Grohe
- Department of Respiratory Diseases, Evangelische Lungenklinik, Berlin, Germany
| | - Margarita Majem
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jonathan W Goldman
- David Geffen School of Medicine at University of California, Los Angeles, California, US
| | - Sang-We Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Terufumi Kato
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Konstantin Laktionov
- Federal State Budgetary Institution N.N.Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO), Moscow, Russia
| | - Huu Vinh Vu
- Department of Thoracic Surgery, Choray Hospital, Ho Chi Minh City, Vietnam
| | - Zhijie Wang
- State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shun Lu
- Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Kye Young Lee
- Precision Medicine Lung Cancer Center, Konkuk University Medical Center, Seoul, South Korea
| | - Charuwan Akewanlop
- Division of Medical Oncology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Filippo de Marinis
- Thoracic Oncology Division, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Laura Bonanno
- Medical Oncology 2, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Manuel Domine
- Oncology department, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain
| | - Frances A Shepherd
- Department of Medical Oncology and Hematology, University Health Network, Princess Margaret Cancer Centre and the University of Toronto, Toronto, Ontario, Canada
| | - Lingmin Zeng
- Late Oncology Statistics, AstraZeneca, Gaithersburg, Maryland, US
| | - Ajlan Atasoy
- Late Oncology Research & Development, AstraZeneca, Cambridge, UK
| | - Roy S Herbst
- Medical Oncology, Yale School of Medicine and Yale Cancer Center, New Haven, Connecticut, US
| | - Masahiro Tsuboi
- Department of Thoracic Surgery and Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Pilleron S, Gower H, Janssen-Heijnen M, Signal VC, Gurney JK, Morris EJ, Cunningham R, Sarfati D. Patterns of age disparities in colon and lung cancer survival: a systematic narrative literature review. BMJ Open 2021; 11:e044239. [PMID: 33692182 PMCID: PMC7949400 DOI: 10.1136/bmjopen-2020-044239] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To identify patterns of age disparities in cancer survival, using colon and lung cancer as exemplars. DESIGN Systematic review of the literature. DATA SOURCES We searched Embase, MEDLINE, Scopus and Web of Science through 18 December 2020. ELIGIBILITY CRITERIA We retained all original articles published in English including patients with colon or lung cancer. Eligible studies were required to be population-based, report survival across several age groups (of which at least one was over the age of 65) and at least one other characteristic (eg, sex, treatment). DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed the quality of included studies against selected evaluation domains from the QUIPS tool, and items concerning statistical reporting. We evaluated age disparities using the absolute difference in survival or mortality rates between the middle-aged group and the oldest age group, or by describing survival curves. RESULTS Out of 3047 references, we retained 59 studies (20 for colon, 34 for lung and 5 for both sites). Regardless of the cancer site, the included studies were highly heterogeneous and often of poor quality. The magnitude of age disparities in survival varied greatly by sex, ethnicity, socioeconomic status, stage at diagnosis, cancer site, and morphology, the number of nodes examined and treatment strategy. Although results were inconsistent for most characteristics, we consistently observed greater age disparities for women with lung cancer compared with men. Also, age disparities increased with more advanced stages for colon cancer and decreased with more advanced stages for lung cancer. CONCLUSIONS Although age is one of the most important prognostic factors in cancer survival, age disparities in colon and lung cancer survival have so far been understudied in population-based research. Further studies are needed to better understand age disparities in colon and lung cancer survival. PROSPERO REGISTRATION NUMBER CRD42020151402.
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Affiliation(s)
- Sophie Pilleron
- Department of Public Health, School of Medicine, University of Otago, Wellington, New Zealand
| | - Helen Gower
- Department of Surgery and Anaesthesia, Surgical Cancer Research Group, University of Otago, Wellington, New Zealand
| | - Maryska Janssen-Heijnen
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands
- Department of Epidemiology, Maastricht University Medical Centre+, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
| | - Virginia Claire Signal
- Department of Public Health, School of Medicine, University of Otago, Wellington, New Zealand
| | - Jason K Gurney
- Department of Public Health, School of Medicine, University of Otago, Wellington, New Zealand
| | - Eva Ja Morris
- Nuffield Department of Population Health, University of Oxford, Big Data Institute, Oxford, UK
| | - Ruth Cunningham
- Department of Public Health, School of Medicine, University of Otago, Wellington, New Zealand
| | - Diana Sarfati
- New Zealand Cancer Control Agency, Wellington, New Zealand
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Zhu Y, Zhai X, Chen S, Wang Z. Exploration of optimal time for initiating adjuvant chemotherapy after surgical resection: A retrospective study in Chinese patients with stage IIIA non-small cell lung cancer in a single center. Thorac Cancer 2016; 7:399-405. [PMID: 27385981 PMCID: PMC4930958 DOI: 10.1111/1759-7714.12342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 01/19/2016] [Indexed: 01/16/2023] Open
Abstract
Background Adjuvant chemotherapy (ACT) can reduce the risk of recurrence and improve survival after surgical resection in non‐small cell lung cancer (NSCLC) patients. We explore the optimal time from surgery to initiation of ACT in Chinese patients with stage IIIA NSCLC. Methods Patients pathologically diagnosed with IIIA NSCLC who underwent radical surgery were included in this study. The cut‐off point of time to initiation of adjuvant chemotherapy (TTAC) was determined by maximally selected log‐rank statistics. Patients were divided into two groups according to the TTAC cut‐off point. Propensity score matching (PSM) was used to eliminate confounding variables, and Kaplan–Meier analysis was used to analyze the impact of TTAC on disease‐free survival (DFS). Results The cut‐off time was 46 days from surgery to the first ACT. Prior to PSM, baseline characteristic variables were balanced with no statistical difference between the groups, except for pathologic subtype and smoking history. No difference in DFS was found between the two groups prior to PSM (P = 0.529); after PSM, the median DFS was consistent between the two (P = 0.822). N2 lymph node station involvement was an independent factor associated with poor survival compared with patients with N0 lymph node involvement. Moderate differentiation and postoperative radiotherapy could improve survival; however, TTAC was not significantly correlated with DFS. Subgroup analyses showed no significant correlation between DFS and different TTAC programs. Conclusion No survival difference was obtained as to when ACT was initiated for patients with stage IIIA NSCLC.
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Affiliation(s)
- Yixiang Zhu
- Department of Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China
| | - Xiaoyu Zhai
- Department of Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China
| | - Sipeng Chen
- School of Public Health Capital Medical University Beijing China
| | - Ziping Wang
- Department of Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China
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Fan H, Shao ZY, Xiao YY, Xie ZH, Chen W, Xie H, Qin GY, Zhao NQ. Incidence and survival of non-small cell lung cancer in Shanghai: a population-based cohort study. BMJ Open 2015; 5:e009419. [PMID: 26700282 PMCID: PMC4691760 DOI: 10.1136/bmjopen-2015-009419] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/02/2015] [Accepted: 10/26/2015] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Large population-based studies on the incidence and outcome of non-small cell lung cancer (NSCLC) are lacking in mainland China. This study aimed to investigate the NSCLC incidence, demographic features and survival as well as factors affecting survival of patients with NSCLC in Shanghai. DESIGN Prospective observational cohort study. SETTING Baseline information was collected from Shanghai Health Information Network, which is based on the Health Information Systems from all the comprehensive hospitals and specialist hospitals qualified for cancer diagnosis in the Shanghai metropolitan area. PARTICIPANTS All NSCLC cases identified from the database between 2011 and 2013 were recruited (15,020 patients). MAIN RESULTS The crude and age-adjusted incidences of NSCLC were 54.20 per 100,000 people (55.90 per 100,000 for men, 52.39 per 100,000 for women) and 39.05 per 100,000 people (41.43 per 100,000 for men and 37.13 per 100,000 for women), respectively. The median survival time was 22.7 months (95% CI 21.8 to 24.2 months) with an overall 1-year survival rate of 71.8% (95% CI 69.8% to 73.8%). The 1-year survival rate was 96.5% (95% CI 94.0% to 98.6%) in patients with stage I NSCLC, 89.1% (95% CI 83.3% to 94.9%) in patients with stage II NSCLC, 78.8% (95% CI 74.1% to 83.5%) in patients with stage IIIa NSCLC and 58.9% (95% CI 56.1% to 61.7%) in patients with stage IIIb/IV NSCLC. Multivariate analysis showed surgical resection (HR=0.607, 95% CI 0.511 to 0.722) and chemotherapy (HR=0.838, 95% CI 0.709 to 0.991) significantly improved survival. Factors associated with poor survival included older age, male sex, larger tumour size, lymph node metastasis, distant metastasis and squamous cell carcinoma. CONCLUSIONS A higher incidence and better survival rates for patients with NSCLC were identified when compared with previously published studies, which may provide evidence on the incidence and survival of NSCLC in China.
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Affiliation(s)
- Heng Fan
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Zhen-Yi Shao
- Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China
| | - Yuan-Yuan Xiao
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Zhi-Hui Xie
- Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China
| | - Wen Chen
- Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China
| | - Hua Xie
- Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China
| | - Guo-You Qin
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Nai-Qing Zhao
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
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What is the extent of the advantage of video-assisted thoracoscopic surgical resection over thoracotomy in terms of delivery of adjuvant chemotherapy following non-small-cell lung cancer resection? Interact Cardiovasc Thorac Surg 2014; 19:656-60. [DOI: 10.1093/icvts/ivu206] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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8
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Jin Y, Zhao L, Peng F. Prognostic impact of serum albumin levels on the recurrence of stage I non-small cell lung cancer. Clinics (Sao Paulo) 2013; 68:686-93. [PMID: 23778417 PMCID: PMC3654299 DOI: 10.6061/clinics/2013(05)17] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 03/10/2013] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Patients with stage I non-small cell lung cancer who have undergone complete surgical resection harbor a 30% risk for tumor recurrence. Thus, the identification of factors that are predictive for tumor recurrence is urgently needed. The aim of this study was to test the prognostic value of serum albumin levels on tumor recurrence in patients with stage I non-small cell lung cancer. METHODS Stage I non-small cell lung cancer patients who underwent complete surgical resection of the primary tumor at Zhejiang Hospital were analyzed in this study. Serum albumin levels were measured before surgery and once again after surgery in 101 histologically diagnosed non-small cell lung cancer patients. Correlations between the pre- and post-operative serum albumin levels and various clinical demographics and recurrence-free survival rates were analyzed. RESULTS Patients with pre-operative hypoalbuminemia (<3.5 g/dl) had a significantly worse survival rate than patients with normal pre-operative serum albumin levels (≥3.5 g/dl) (p=0.008). Patients with post-operative hypoalbuminemia had a worse survival rate when compared with patients with normal post-operative serum albumin levels (p=0.001). Cox multivariate analysis identified pre-operative hypoalbuminemia, post-operative hypoalbuminemia and tumor size over 3 cm as independent negative prognostic factors for recurrence. CONCLUSION Serum albumin levels appear to be a significant independent prognostic factor for tumor recurrence in patients with stage I non-small cell lung cancer who have undergone complete resection. Patient pre-treatment and post-treatment serum albumin levels provide an easy and early means of discrimination between patients with a higher risk for recurrence and patients with a low risk of recurrence.
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Affiliation(s)
- Ying Jin
- Zhejiang Cancer Hospital, Department of Medical Oncology, Hangzhou, China
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