Author of

• 12495

  +

  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12535

    +

    P3.07-040 - Temporal trends in surgical outcomes for early stage non-small cell lung cancer (ID 2958)

    09:30 - 09:30  |  Author(s): B.M. Robinson
    • Abstract

    Background
    There has been little investigation of temporal trends in outcomes following resection of early non-small cell lung cancer. Analyses are easily confounded by changes in patient characteristics and variations in background mortality when assessing all-cause survival. This study aimed to evaluate changes in patient characteristics, tumour factors and survival over time.There has been little investigation of temporal trends in outcomes following resection of early non-small cell lung cancer. Analyses are easily confounded by changes in patient characteristics and variations in background mortality when assessing all-cause survival. This study aimed to evaluate changes in patient characteristics, tumour factors and survival over time.

    Methods
    A retrospective analysis of 2816 consecutive pathological stage 1A to 3A patients, treated by surgical resection between 1984 and 2007 was performed. Patients were divided into four 6-year eras by date of surgery. Relative survival probabilities were estimated by era and TNM stage. Expected survival was calculated from national age, sex and period specific mortality rates. Multivariable regression using a generalised linear model with Poisson error was used to estimate the excess hazard of death in each era, using the 1984-1989 cohort as the baseline, controlling for age, sex, extent of resection, margin status, tumour stage and cell type.

    Results
    In later eras, patients were older, had a greater proportion of adenocarcinomas and stage 1A tumours. Relative 5-year survival rates for 1984-1989, 1990-1995, 1996-2001 and 2002-2007 were 45.4, 49.6, 48.5 and 57.9% respectively. There was a significant improvement in 5-year relative survival in the 2002-2007 cohort (Excess hazard ratio 0.62, p<0.001). Age ≥75, increasing TNM stage, positive margins and mixed cell type were also significant prognostic factors. The increased survival demonstrated in the most recent era can be attributed primarily to survival gains in stage IIa/b and stage 3a (Figure). Figure 1

    Conclusion
    Temporal trends in patient characteristics in this series mirror recent epidemiological data for non-small cell lung cancer. After controlling for known confounders and background mortality variation, improved survival was demonstrated for more recent patients. Advances in clinical staging and adjuvant therapy may explain these findings.