Conditional Survival of Surgically Treated Patients with Lung Cancer: A Comprehensive Analyses of Overall, Recurrence-free, and Relative Survival
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose Survival probability changes over time in cancer survivors. This study examined conditional survival in patients undergoing curative resection for non-small cell lung cancer (NSCLC). Materials and Methods Five-year conditional recurrence-free survival (CRFS), conditional overall survival (COS), and conditional relative survival (CRS) up to 10 years after surgery were calculated in patients who underwent NSCLC resection from 1994 to 2016. These rates were stratified according to age, sex, year of diagnosis, pathological stage, tumor histology, smoking status, comorbidity, and lung function. Results Five-year CRFS increased from 65.6% at baseline to 90.9% at 10 years after surgery. Early differences in 5-year CRFS according to stratified patient characteristics disappeared, except for age: older patients exhibited persistently lower 5-year CRFS. Five-year COS increased from 72.7% to 78.3% at 8 years and then decreased to 75.4% at 10 years. Five-year CRS increased from 79.0% at baseline to 86.8% at 10 years. Older age and higher pathologic stage were associated with lower 5-year COS and CRS up to 10 years after surgery. Female patients, those with adenocarcinoma histology, non-smokers, patient without comorbidities and had good lung function showed higher COS and CRS. Conclusion CRFS improved over time, but significant risk remained after 5 years. CRS slightly improved over time but did not reach 90%, suggesting significant excess mortality compared to the general population. Age and stage remained significant predictors of conditional survival several years after surgery. Our conditional survival estimates should help clinicians and patients make informed treatment and personal life decisions based on survivorship status.
Abstract
Purpose Survival probability changes over time in cancer survivors. This study examined conditional survival in patients undergoing curative resection for non-small cell lung cancer (NSCLC). Materials and Methods Five-year conditional recurrence-free survival (CRFS), conditional overall survival (COS), and conditional relative survival (CRS) up to 10 years after surgery were calculated in patients who underwent NSCLC resection from 1994 to 2016. These rates were stratified according to age, sex, year of diagnosis, pathological stage, tumor histology, smoking status, comorbidity, and lung function. Results Five-year CRFS increased from 65.6% at baseline to 90.9% at 10 years after surgery. Early differences in 5-year CRFS according to stratified patient characteristics disappeared, except for age: older patients exhibited persistently lower 5-year CRFS. Five-year COS increased from 72.7% to 78.3% at 8 years and then decreased to 75.4% at 10 years. Five-year CRS increased from 79.0% at baseline to 86.8% at 10 years. Older age and higher pathologic stage were associated with lower 5-year COS and CRS up to 10 years after surgery. Female patients, those with adenocarcinoma histology, non-smokers, patient without comorbidities and had good lung function showed higher COS and CRS. Conclusion CRFS improved over time, but significant risk remained after 5 years. CRS slightly improved over time but did not reach 90%, suggesting significant excess mortality compared to the general population. Age and stage remained significant predictors of conditional survival several years after surgery. Our conditional survival estimates should help clinicians and patients make informed treatment and personal life decisions based on survivorship status.
참고문헌 (32)
- Lin HT, "Epidemiology and survival outcomes of lung cancer : a population-based study", Biomed Res Int, 2019, pp.8148156~ (2019)
- Merrill RM, "Conditional survival among cancer patients in the United States", Oncologist, 15, pp.873~882 (2010)
- Wang SJ, "Ethnic disparities in conditional survival of patients with non-small cell lung cancer", J Thorac Oncol, 2, pp.180~190 (2007)
- Henson DE, "On the estimation of survival", Semin Surg Oncol, 10, pp.2~6 (1994)
- Skuladottir H, "Conditional survival of patients with the four major histologic subgroups of lung cancer in Denmark", J Clin Oncol, 21, pp.3035~3040 (2003)
- Merrill RM, "Conditional survival among patients with carcinoma of the lung", Chest, 116, pp.697~703 (1999)
- Janssen-Heijnen ML, "Clinical relevance of conditional survival of cancer patients in europe : age-specific analyses of 13 cancers", J Clin Oncol, 28, pp.2520~2528 (2010)
- Groth SS, "Conditional cancer-specific versus cardiovascular-specific survival after lobectomy for stage I nonsmall cell lung cancer", Ann Thorac Surg, 90, pp.375~382 (2010)
- Liang Y, "Conditional survival analysis of four treatment strategies for patients with stage I non-small cell lung cancer", Oncol Lett, 18, pp.1089~1098 (2019)
- Fukui T, "Conditional survival after surgical intervention in patients with non-small cell lung cancer", Ann Thorac Surg, 101, pp.1877~1882 (2016)
- Kim W, "Dynamic prognostication using conditional survival analysis for patients with operable lung adenocarcinoma", Oncotarget, 8, pp.32201~32211 (2017)
- Yoo JE, "Conditional relative survival and competing mortality in patients who underwent surgery for lung cancer : a nationwide cohort study", Int J Cancer, 148, pp.626~636 (2021)
- Martini N, "Multiple primary lung cancers", J Thorac Cardiovasc Surg, 70, pp.606~612 (1975)
- Antakli T, "Second primary lung cancer", Ann Thorac Surg, 59, pp.863~866 (1995)
- Su S, "Patterns of survival and recurrence after surgical treatment of early stage non-small cell lung carcinoma in the ACOSOG Z0030(ALLIANCE)trial", J Thorac Cardiovasc Surg, 147, pp.747~752 (2014)
- Jaklitsch MT, "The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups", J Thorac Cardiovasc Surg, 144, pp.33~38 (2012)
- Tsutani Y, "High-risk factors for recurrence of stage I lung adenocarcinoma : follow-up data from JCOG0201", Ann Thorac Surg, 108, pp.1484~1490 (2019)
- Janssen-Heijnen ML, "Prognosis for long-term survivors of cancer", Ann Oncol, 18, pp.1408~1413 (2007)
- Rich AL, "Non-small cell lung cancer in young adults : presentation and survival in the English National Lung Cancer Audit", QJM, 108, pp.891~897 (2015)
- Bossard N, "Survival of cancer patients in France : a population-based study from The Association of the French Cancer Registries(FRANCIM)", Eur J Cancer, 43, pp.149~160 (2007)
- Wisnivesky JP, "Sex differences in lung cancer survival: do tumors behave differently in elderly women?", J Clin Oncol, 25, pp.1705~1712 (2007)
- North CM, "Women and lung cancer: what is new?", Semin Thorac Cardiovasc Surg, 25, pp.87~94 (2013)
- Jung KW, "Do female cancer patients display better survival rates compared with males? Analysis of the Korean National Registry data, 2005-2009", PLoS One, 7, pp.e52457~ (2012)
- Cheng TY, "The international epidemiology of lung cancer : latest trends, disparities, and tumor characteristics", J Thorac Oncol, 11, pp.1653~1671 (2016)
- Tanner NT, "Assessing the generalizability of the National Lung Screening Trial : comparison of patients with stage 1 disease", Am J Respir Crit Care Med, 196, pp.602~608 (2017)
- Vijayvergia N, "Survivorship in nonsmall cell lung cancer : challenges faced and steps forward", J Natl Compr Canc Netw, 13, pp.1151~1161 (2015)
- Yoon DW, "Increased risk of coronary heart disease and stroke in lung cancer survivors : a Korean nationwide study of 20, 458patients", Lung Cancer, 136, pp.115~121 (2019)
- Ezeife DA, "Personalized medicine for non-small cell lung cancer: where are we now and where can we go?", Expert Rev Respir Med, 12, pp.81~82 (2018)
- Wu CF, "Recurrence risk factors analysis for stage I non-small cell lung cancer", Medicine (Baltimore), 94, pp.e1337~ (2015)
- Basbug Tezel Y, "Impact of persistence of smoking on recurrence after early stage lung surgery", Eur Res J, 48, pp.PA4339~ (2016)
- Jassem J, "Tobacco smoking after diagnosis of cancer: clinical aspects", Transl Lung Cancer Res, 8(Suppl 1), pp.S50~S58 (2019)
- Shin DW, "A national survey of lung cancer specialists’ views on lowdose CT screening for lung cancer in Korea", PLoS One, 13, pp.e0192626~ (2018)