Factors associated with diagnosis of stages I and II lung cancer: a multivariate analysis

Abstract

OBJECTIVE To present the overall survival rate for lung cancer and identify the factors associated with early diagnosis of stage I and II lung cancer. METHODS This is a retrospective cohort study including individuals diagnosed with lung cancer, from January 2009 to December 2017, according to the cancer registry at UMass Memorial Medical Center. Five-year overall survival and its associated factors were identified by Kaplan–Meier curves and Cox’s proportional hazards model. Factors associated with diagnosing clinical stage I and II lung cancer were identified by bivariate and multivariate backward stepwise logistic regression (Log-likelihood ratio (LR)) at 95% confidence interval (CI). RESULTS The study was conducted with data on 2730 individuals aged 67.9 years on average, 51.5% of whom female, 92.3% white, and 6.6% never smoked. Five-year overall survival was 21%. Individuals diagnosed with early-stage disease had a 43% five-year survival rate compared to 8% for those diagnosed at late stages. Stage at diagnosis was the main factor associated with overall survival [HR = 4.08 (95%CI: 3.62–4.59)]. Factors associated with early diagnosis included patients older than 68 years [OR = 1.23 (95%CI: 1.04–1.45)], of the female gender [OR = 1.47 (95%CI: 1.24–1.73)], white [OR = 1.63 (95%CI: 1.16–2.30)], and never-smokers [OR = 1.37 (95%CI: 1.01–1.86)]; as well as tumors affecting the upper lobe [OR = 1.46 (95%CI: 1.24–1.73)]; adenocarcinoma [OR = 1.43 (95%CI: 1.21–1.69)]; and diagnosis after 2014 [OR = 1.61 (95%CI: 1.37–1.90)]. CONCLUSIONS Stage at diagnosis was the most decisive predictor for survival. Non-white and male individuals were more likely to be diagnosed at a late stage. Thus, promoting lung cancer early diagnosis by improving access to health care is vital to enhance overall survival for individuals with lung cancer.

Clinical Efficacy of Single-Port Thoracoscopic Lobectomy versus Three-Port Thoracoscopic Lobectomy for Lung Cancer

“…Kamigaichi Atsushi et al found that the number and length of incisions were closely related to muscle, nerve, and vascular injuries in patients [ 18 ] because small incisions are less liable to chest muscles injury, which can reduce the stimulation of surgical operations on muscles and nerves. Moreover, the single-port operation allows for more effective hemostasis and less fluctuation of the patient's cellular and humoral immunity [ 13 , 20 , 21 ]; thus, single-port operation avoids collateral damages to the adjacent tissues, reduces the stress response, and alleviates postoperative pain.…”

“…The outcomes are as follows: Baseline data: gender, weight, BMI, tumor stage, pathological type, tumor sites, and tumor size of patients Surgical indices: the surgical indices include operative time, incision length, intraoperative bleeding, intraoperative conversion to thoracotomy, number of lymph nodes dissection, postoperative drainage time, extubation time, length of hospital stay, and pain scores at different time points. The pain score was scaled per the postoperative numerical rating scale (NRS) [ 13 ], and the comparison of pain scores was carried out at 1 d, 3 d, and 7 d postoperatively. The NRS is a 10-point sliding scale with the number 1 to 10 for patients to describe their pain by circling out the number matching their conditions.…”

Delays in Lung Cancer Diagnosis: Observations from a Tertiary Care Centre in Kerala, India

“…1,3,4 Timely diagnosis is critical in lung cancer because the treatment outcomes correspond to the stage at diagnosis. 5,6 However, data suggest that the majority of lung cancer patients are diagnosed at an advanced stage with distant metastasis, resulting in poor prognosis. 7,8 The delays could be at multiple levels.…”

Detection and Quantification of Tp53 and p53-Anti-p53 Autoantibody Immune Complex: Promising Biomarkers in Early Stage Lung Cancer Diagnosis

“…Lung cancer is a leading cause of death worldwide, claiming nearly 1.80 million lives in 2020 [ 1 ]. The overall 5-year relative survival rate for lung cancer is 21% [ 2 , 3 ]. However, if diagnosed at a localized stage, the 5-year survival rate is 59%.…”