Format

Send to

Choose Destination

See 1 citation found by title matching your search:

J Natl Cancer Inst. 2015 Mar 23;107(6):djv059. doi: 10.1093/jnci/djv059. Print 2015 Jun.

Lung cancer prognosis before and after recurrence in a population-based setting.

Author information

1
Epidemiology Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy (DC, PAB, ACP); Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA (MP); Genetic Epidemiology Branch (MP, MRo, AG, LG, NEC, MAT, MTL) and Biostatistics Branch (MHG, JL, SW), Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD; Department of Clinical Sciences and Community Health, Universita' degli Studi di Milano, Milan, Italy (MRu, PAB, ACP).
2
Epidemiology Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy (DC, PAB, ACP); Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA (MP); Genetic Epidemiology Branch (MP, MRo, AG, LG, NEC, MAT, MTL) and Biostatistics Branch (MHG, JL, SW), Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD; Department of Clinical Sciences and Community Health, Universita' degli Studi di Milano, Milan, Italy (MRu, PAB, ACP). landim@mail.nih.gov gailm@mail.nih.gov.

Abstract

BACKGROUND:

Population-based estimates of absolute risk of lung cancer recurrence, and of mortality rates after recurrence, can inform clinical management.

METHODS:

We evaluated prognostic factors for recurrences and survival in 2098 lung cancer case patients from the general population of Lombardy, Italy, from 2002 to 2005. We conducted survival analyses and estimated absolute risks separately for stage IA to IIIA surgically treated and stage IIIB to IV non-surgically treated patients.

RESULTS:

Absolute risk of metastases exceeded that of local recurrence in every stage and cell type, highlighting the systemic threat of lung cancer. In stage I, the probability of dying within the first year after diagnosis was 2.7%, but it was 48.3% within first year after recurrence; in stage IV, the probabilities were 57.3% and 80.6%, respectively. Over half the patients died within one year of first metastasis. Although in stages IA to IB about one-third of patients had a recurrence, stage IIA patients had a recurrence risk (61.2%) similar to stage IIB (57.9%) and IIIA (62.8%) patients. Risk of brain metastases in stage IA to IIIA surgically treated non-small cell lung cancer patients increased with increasing tumor grade. Absolute risk of recurrence was virtually identical in adenocarcinoma and squamous cell carcinoma patients.

CONCLUSIONS:

This population-based study provides clinically useful estimates of risks of lung cancer recurrence and mortality that are applicable to the general population. These data highlight the need for more effective adjuvant treatments overall and within specific subgroups. The estimated risks of various endpoints are useful for designing clinical trials, whose power depends on absolute numbers of events.

PMID:
25802059
PMCID:
PMC4838060
DOI:
10.1093/jnci/djv059
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center