Histology-related variation in the treatment and survival of patients with lung carcinoma in Canada

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2003-11, Vol.42 (2), p.127-139
• Main Authors: Xie, Lin, Ugnat, Anne-Marie, Morriss, Judy, Semenciw, Robert, Mao, Yang
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - radiotherapy; Carcinoma, Small Cell - drug therapy; Carcinoma, Small Cell - pathology; Carcinoma, Small Cell - radiotherapy; Child; Child, Preschool; Combined Modality Therapy; Female; Follow-Up Studies; Histology; Humans; Infant; Infant, Newborn; Limited-extensive stage; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Lung Neoplasms - radiotherapy; Male; Medical sciences; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Pneumology; Prognosis; Prognostic factor; Relative survival analysis; Survival Analysis; TNM stage; Treatment; Tumors of the respiratory system and mediastinum
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/S0169-5002(03)00283-6

Objectives: The aim of the study was to examine histologic differences in lung cancer treatment and survival, and to define recent survival trends in Ottawa, Canada. Methods: From 1994 to 2000, 3237 patients with invasive lung cancer were registered at the Ottawa Regional Cancer Centre (ORCC) and were followed up to 31 December 2001. Five-year relative survival rates (RSRs) and relative excess risks (RERs) of dying were calculated by stage and dominant initial treatment modalities for major cellular histologies using a relative survival model. Results: The overall 5-year survival rate was 14%, and female patients had significantly better survival. Patients with stage I and II non-small cell lung cancer (NSCLC) who were treated by surgery alone were more likely to survive (5-year RSRs were 72 and 48%, respectively) than those who received other treatments. Patients with stage III NSCLC had a 5-year survival rate of 9% after chemotherapy plus radiotherapy, whereas stage IV patients who received only chemotherapy had better survival for up to 2 years than patients with other treatments. In cases of limited-stage small cell lung cancer (SCLC), survival was better for patients who received chemotherapy plus radiotherapy than for those who received only chemotherapy. Conclusions: The relatively superior survival of surgical patients with stage I NSCLC implies that a considerable number of patients have the potential to be treated successfully. The overall poor survival of lung cancer patients suggests a need for more national public health emphasis on lung cancer prevention, improved screening and early diagnosis, and better treatment.