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Improvement of survival for non-small cell lung cancer over time

Authors Xia W, Yu X, Mao Q, Xia W, Wang A, Dong G, Chen B, Ma W, Xu L, Jiang F

Received 28 June 2017

Accepted for publication 26 July 2017

Published 29 August 2017 Volume 2017:10 Pages 4295—4303

DOI https://doi.org/10.2147/OTT.S145036

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Manfred Beleut

Peer reviewer comments 2

Editor who approved publication: Dr Yao Dai

Wenjie Xia,1–3,* Xinnian Yu,4,* Qixing Mao,1–3,* Wenying Xia,5 Anpeng Wang,1–3 Gaochao Dong,1,2 Bing Chen,1–3 Weidong Ma,1–3 Lin Xu,1,2 Feng Jiang1,2

1Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital; 2Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Cancer Institute of Jiangsu Province, 3The Fourth Clinical College of Nanjing Medical University, 4Department of Chemotherapy, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, 5Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

*These authors contributed equally to this work

Abstract: Non-small cell lung cancer (NSCLC) is the main histological subtype of lung cancer, which is the leading cause of cancer death. It is unclear whether the improved survival seen at high-volume centers applies to the general population and, more importantly, whether the improvement in lung cancer survival was just a consequence of improved screening work. Data from the Surveillance, Epidemiology, and End Results (SEER) registry was used to identify 405,580 patients with NSCLC diagnosed from 1988 to 2008. The patients were divided into four groups according to the year of diagnosis. Trends of clinical characteristics were analyzed to reflect the progress of screening work. Five-year relative survivals in various subgroups were compared. The results indicated that proportion of aged, advanced, and non-surgical patients increased, whereas patients with lymph node metastasis and high histology grade decreased. Improvements in all stages of NSCLC patients were demonstrated, with relatively more significant gains for patients with localized and regional disease. After potentially curative surgical resection, remarkable improvements were observed in both cohorts with time (surgical: 52.00%–63.00%; non-surgical: 6.10%–13.50%). Specifically, patients who underwent pneumonectomy, lobectomy/bilobectomy, and partial/wedge/segmental resection all presented better survival rates. Our SEER analysis demonstrated improvements among patients in all stages of NSCLC that were deemed attributable to improved therapy and medical care for NSCLC rather than improved screening work.

Keywords: NSCLC, survival, SEER, screening, surgery
 

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