Twenty-Year Survival of Patients Operated on for Non-Small-Cell Lung Cancer: The Impact of Tumor Stage and Patient-Related Parameters

Cancers

Yves Lecarpentier¹  Hervé Dermine²  Diane Damotte³  Audrey Lupo³  Olivier Schussler⁴  Marco Alifano⁴  Antonio Bobbio⁴ 

[1] Centre de Recherche Clinique, Grand Hôpital de l’Est Francilien (GHEF), 77120 Coulommiers, France;Department of Anesthesia and Surgical Intensive Care, Cochin Hospital, APHP Centre Paris University, 75014 Paris, France;Pathology Department, Paris Center University Hospitals, AP-HP, University Paris Descartes, 75006 Paris, France;Thoracic Surgery Department, Cochin Hospital, APHP Centre Paris University, 75014 Paris, France;

关键词: lung cancer;    surgery;    outcome;    very long-term survival;    prognostic factors;   

DOI  :  10.3390/cancers14040874

来源: DOAJ

【 摘 要 】

Surgery is the mainstay treatment of non-small-cell lung cancer (NSCLC), but its impact on very-long-term survival (beyond 15 years) has never been evaluated. Methods: All patients operated on for major lung resection (Jun. 2001–Dec. 2002) for NSCL in the Thoracic Surgery Department at Paris-Hôtel-Dieu-University-Hospital were included. Patients‘ characteristics were prospectively collected. Vital status was obtained by checking INSEE database and verifying if reported as “non-death” by the hospital administrative database and direct phone interviews with patients of families. Results: 345 patients were included. The 15- and 20-year survival rates were 12.2% and 5.7%, respectively. At univariate analysis, predictors of worse survivals were: increasing age at surgery (p = 0.0042), lower BMI (p = 0.009), weight loss (p = 0.0034), higher CRP (p = 0.049), pathological stage (p = 0.00000042), and, among patients with adenocarcinoma, higher grade (p = 0.028). Increasing age (p = 0.004), cumulative smoking (p = 0.045), lower BMI (0.046) and pathological stage (p = 0.0026), were independent predictors of long-term survival at Cox multivariate analysis. In another model, increasing age (p = 0.013), lower BMI (p = 0.02), chronic bronchitis (p = 0.03), lower FEV1% (p = 0.00019), higher GOLD class of COPD (p = 0.0079), and pathological stage (p = 0.000024), were identified as independent risk factors. Conclusions: Very-long-term survivals could be achieved after surgery of NSCLC, and factors classically predicting 5- and 10-years survival also determined longer outcomes suggesting that both initial tumor aggressiveness and host’s characteristics act beyond the period usually taken into account in oncology.

【 授权许可】

Unknown