Early mortality in lung cancer: French prospective multicentre observational study

Abstract

BackgroundDespite the progress seen in the last decade in diagnosis and treatment, lung cancer has still a bad prognosis and a substantial number of patients died within the weeks following diagnosis. The objective of this study was to quantify early mortality in lung cancer, to identify patients who are at high risk of early decease, and to describe their management in a real world.MethodsProspective observational study including consecutively all adult patients managed for primary lung cancer histologically or cytologically diagnosed in 2010 in the respiratory medicine department of one of the participating French general hospitals. Patients and cancer characteristics and first therapeutic strategy were collected at diagnosis. Dates of death were obtained from investigators or town council of the patient’s birth place. All fatal cases were considered regardless of the cause of the death. Multivariate logistic regression model was used to determine the factors significantly and independently associated with death at 1 and 3 months.ResultsSeven thousand fifty-one patients from 104 centres were included in the study. Vital status was obtained for 6,981 patients. Respectively, 678 (9.7 %) and 1,621 (23.2 %) of the 6,981 patients with available data died within 1 and 3 months following diagnosis. As compared with the other patients, they were significantly older and frailer (based on performance status [PS] and recent weight loss) and more frequently reported stage IV tumour. Overall, 64.5 % (1 month) and 42.8 % (3 months) of patients had no cancer therapy and less than 1 % were included in a therapeutic trial.ConclusionAbout one in four patients died within 3 months following lung cancer diagnosis. Early mortality mainly involves frail patients with advanced cancer and is associated with lack of cancer therapy. This supports the need for early diagnosis and clinical trials in this population. Reducing early mortality to give supplementary time to patients to organise the future is a major challenge for 21st century physicians.

miRNA-148a serves as a prognostic factor and suppresses migration and invasion through Wnt1 in non-small cell lung cancer

“…Survival times was calculated in months and defined as the time from operation time until death, or censored if no death was noted at follow-up date. Similar to previous reports[ 17 – 20 ], there were 8 (4.85%) patients who died within 3 month after operation, and the cause of this early mortality after surgical resection was closely related to postoperative complications with no sign of recurrent disease. So these patients were also defined as censored data.…”

Risk factors for early mortality of lung cancer patients in France: A nationwide analysis

“…Certain factors associated with early mortality highlighted in our analysis were previously reported, especially age, 13,15,18,26 metastatic disease at diagnosis, 8,15 and male sex 13–15,18 . A recent study of the SEER registry about gender and lung cancer 27 suggests found that male patients were more likely than female patients to be diagnosed at stage III or IV, consistent across lung cancer types, cancer registries, smoking, and socioeconomic backgrounds.…”

“…This early‐mortality rate of 19% was lower than that found in other studies. In their 2010 prospective, multicenter study that included 7051 patients with newly diagnosed lung cancers, Grivaux et al 15 reported 23.2% 3‐month mortality. According to an analysis of a United Kingdom medical‐administrative database with 20,142 patients diagnosed with lung cancer between January 2000 and January 2013, 3‐month mortality was 30.2% 14 .…”

Histone deacetylase�5 promotes the proliferation and invasion of lung cancer cells

“…Most lung cancers are squamous cell carcinomas, small cell carcinomas or adenocarcinomas (21). The prognosis of patients with lung cancer is still less than satisfactory, and the 5-year survival rate does not exceed 15% (2)(3)(4)(5). This is mainly due to the fact that many key factors regulating the malignant phenotype of lung cancer have not been studied clearly.…”

“…Despite significant progress seen in the last decade in regards to treatment regimens including surgery, radiotherapy and chemotherapy, and ongoing research development, the survival rate of patients with lung cancer is still less than satisfactory. A substantial number of patients succumb to the disease within the weeks following diagnosis, and the 5-year survival rate does not exceed 15% (2)(3)(4)(5). The poor prognosis of lung cancer mainly results from its high degree of malignancy (malignant proliferation, invasion and migration).…”