The Changing Pattern of Non-Small Cell Lung Cancer Between the 90th and 2000th Decades§
Jesus Montesinos*, 1, Marisa Bare2, Elsa Dalmau3, Eugeni Saigi3, Pablo Villace4, Miquel Nogue5, Miquel Angel Segui3, Anna Arnau1, Xavier Bonfill6
1 Fundació Althaia, Manresa, Barcelona, Clinical Research Unit, Spain
2 Corporació Sanitària Parc Taulí, Institut Universitari (UAB), Sabadell, Barcelona, Department of Epidemiology-Cancer Screening, UDIAT-CD, Spain
3 Corporació Sanitària Parc Taulí Institut Universitari, (UAB), Sabadell, Barcelona, Department of Medical Oncology, Spain
4 Corporació Sanitària Parc Taulí, Institut Universitari, (UAB), Sabadell, Barcelona, Department of Internal Medicine, Spain
5 Hospital General de Vic, Barcelona, Department of Medical Oncology, Spain
6 Department of Clinical Epidemiology and Public Health, CIBERESP (CIBER de Epidemiología y Salud Pública), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
In Europe, approximately 381,500 patients are diagnosed with non-small cell lung cancer (NSCLC) every year. The aim of this study is to analyse the changes in diagnosis, treatment and evolution during the last two decades, using data from a hospital registry.
Material and Methods:
Patients diagnosed with NSCLC at the Corporació Sanitària Parc Taulí-Sabadell (Catalonia, Spain) during the periods 1990-1997 (n=748) and 2003-2005 (n=311) were included. The hospital tumour registry was used for prospective data collection.
Our series shows a significant increase in women diagnosed with NSCLC (6% vs 10.3%; p 0.01) in the latter period; the incidence of adenocarcinomas increased by 20% (31% vs 51.1%), whereas that of squamous cell carcinomas fell (51.3% vs 32.5%; p<0.001). The proportion of patients receiving active treatment also increased significantly, from 56.6% to 76.5% (p<0.001). Disease stage at diagnosis and the number of patients treated by radical surgical resection remained unchanged. Among the favourable independent prognostic factors for survival were: gender (women), age less than 70 years old, Karnofsky index ≥70%, early stage at diagnosis, treatment with chemotherapy, and being diagnosed in the latter period 2003-2005 (HR 0.67). Over this 10-year period, absolute gain in mean survival in our series was 115 days.
The absolute gain in mean survival in NSCLC patients in the period studied was 3.8 months, with a 6.75% increase in 5-year survival. Hospital registry data may help the correct assessment of epidemiological changes and the real effectiveness of treatments, which are sometimes overestimated in clinical trials.
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* Address correspondence to this author at the Unitat de Recerca i Innovació, Fundacio Althaia. Xarxa Assistencial de Manresa, c/ Dr Joan Soler 1-3, 08243 Manresa – Barcelona, Spain; Tel: (+34) 938732100; Fax: (+34) 938732108; E-mail: firstname.lastname@example.org