Survival improvement in patients with non–small cell lung cancer between 1983 and 2012: Analysis of the Surveillance, Epidemiology, and End Results database

Abstract

Non-small cell lung cancer is the most common malignancy in males; it constitutes the majority of lung cancer cases and requires massive medical resources. Despite improvements in managing non-small cell lung cancer, long-term survival remains very low. This study evaluated survival improvement in patients with non-small cell lung cancer in each decade between 1983 and 2012 to determine the impact of race, sex, age, and socioeconomic status on the survival rates in these patients. We extracted data on non-small cell lung cancer cases in each decade between 1983 and 2012 from the Surveillance, Epidemiology, and End Results registries. In total, 573,987 patients with non-small cell lung cancer were identified in 18 Surveillance, Epidemiology, and End Results registry regions during this period. The 12-month relative survival rates improved slightly across three decades, from 39.7% to 40.9% to 45.5%, with larger improvement in the last two decades. However, the 5-year-relative survival rates were very low, with 14.3%, 15.5%, and 18.4%, respectively, in three decades, indicating the urgency for novel comprehensive cancer care. In addition, our data demonstrated superiority in survival time among non-small cell lung cancer patients of lower socioeconomic status and White race. Although survival rates of non-small cell lung cancer patients have improved across the three decades, the 5-yearrelative survival rates remain very poor. In addition, widening survival disparities among the race, the sex, and various socioeconomic status groups were confirmed. This study will help in predicting future tendencies of incidence and survival of non-small cell lung cancer, will contribute to better clinical trials by balancing survival disparities, and will eventually improve the clinical management of non-small cell lung cancer.

Survival Comparison in Patients with Stage IV Lung Cancer in Academic versus Community Centers in the United States

“…One group used the Surveillance, Epidemiology, and End Results database to show increasing overall survival in metastatic NSCLC between 1990 and 2005 and also noted the beginnings of a survival advantage in adenocarcinoma over squamous cell carcinoma at their later time point. 10 Other groups have shown increasing survival in all stages of NSCLC over time across periods spanning the 1980s to the 2000s 11,27 ; however, these studies were limited by their lack of multivariable analyses to control for confounding factors that could have changed over time. These studies also did not conduct analyses based on type of treatment facility, which have largely been limited in the literature to analyses of practice patterns 14,[17][18][19]28 and outcomes in focused subgroups of care 16,17,19,29 rather than across an entire category of NSCLC as we have done in this study.…”

“…Our findings of improved survival in stage IV NSCLC are consistent with the literature. 10,11,27 Our study design offers several advantages compared with that in prior studies. Morgensztern et al 10 uses a multivariate analysis of survival curves with selection of predictors similar to ours; however, their study did not allow for control of stage migration; by comparing ACs with CCs, our study offers an internal control for these effects and also carries the analysis 5 years further.…”

“…Furthermore, prior data in the NCDB literature has shown a similar increase in stage IV NSCLC diagnoses between 1998 and 2006 across treatment facility type (from 36% to 41.5% and from 34.3% to 39.3% in each of the CC groups and from 34.4% to 38.3% in the AC group), 30 making stage migration an unlikely confounder in a comparison between ACs and CCs. Our multivariable analysis was also able to control for confounders for which two other groups 11,27 did not control across time. We have further developed and confirmed a survival advantage arising in adenocarcinoma over time and shown a trend toward significance in treatment of adenocarcinoma at ACs versus at CCs.…”

A molecular and staging model predicts survival in patients with resected non-small cell lung cancer

“…Almost 80% of all lung cancer deaths were non-small cell lung cancer (NSCLC). The overall survival of NSCLC remains poor, although there are tremendous developments of treatments [ 2 ]. Tumor-node-metastasis (TNM) system is widely used to estimate the outcome of patients with NSCLC in current clinical practice.…”

17α-Ethynylestradiol and 4-Nonylphenol Stimulate Lung Adenocarcinoma Cells Production in Xenoestrogenic Way

“…Lung cancer results in high mortality for decades worldwide. Although many evidences have demonstrated the association between smoking and lung cancer incidence, there are still many female patients with lung cancer who never smoke [1]. Therefore, sexual difference is taken into consideration for carcinogenesis and estrogen is supposed to be a risk factor [2,3].…”