Anja Gouliaev, Janna Berg, Azza A Khalil, Susanne O Dalton, Torben R Rasmussen, Niels L Christensen
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引用次数: 0
Abstract
Background: Long-term survival of patients with non-small cell lung cancer (NSCLC) is considerably higher in Norway compared to Denmark, even though diagnostic work-up, treatment, and follow-up are comparable. We aim to explore factors behind favorable long-term survival for lung cancer patients in Norway compared to Denmark.
Method: A retrospective cohort study of patients with NSCLC diagnosed between 2014 and 2016. From the Danish Lung Cancer Registry, 1000 patients were randomly selected, and 974 patients were included. From the Norwegian Vestfold Hospital Trust, 220 patients were randomly selected, and 218 were included. Data from medical records were obtained for all patients. The Danish and Norwegian cohorts were compared using the Pearson chi squared test and multivariate logistic regression analysis.
Results: The two cohorts were comparable in terms of age, sex, and smoking history. However, the Danish patients had a higher number of pack-years (43.5 vs 34.5 p < 0.001) and more comorbidities. The Norwegian patients had less advanced disease stage (p < 0.001), and a larger proportion was treated with curative intent (90 (41.3%) vs 343 (35.2%), p = 0.063). One-year survival was similar, but the 5-year survival was superior in the Norwegian cohort (58 (26.6%) vs 177 (18.2%), p = 0.005). In a multivariate logistic regression model, adjusted for sex, smoking history, performance status, TNM stage and comorbidity, the odds ratio of being a five-year survivor in Norway was 1.81 (95% CI: 1.11-2.94) compared to Denmark.
Conclusions: We found a higher proportion of Norwegian patients diagnosed at potential curable stage and fewer heavy smokers compared to Danish patients. This could contribute to the superior long-term survival found in Norwegian NSCLC patients.
背景:与丹麦相比,挪威非小细胞肺癌(NSCLC)患者的长期存活率要高得多,尽管诊断工作、治疗和随访工作与丹麦不相上下。我们旨在探讨挪威肺癌患者的长期生存率高于丹麦的原因:方法:对2014年至2016年间确诊的NSCLC患者进行回顾性队列研究。我们从丹麦肺癌登记处随机抽取了1000名患者,并纳入了974名患者。从挪威维斯特福德医院信托基金中随机抽取了220名患者,纳入了218名患者。从医疗记录中获得了所有患者的数据。通过皮尔逊卡方检验和多变量逻辑回归分析,对丹麦和挪威队列进行了比较:结果:两组患者在年龄、性别和吸烟史方面具有可比性。然而,丹麦患者的吸烟包年数更高(43.5 对 34.5 p p p = 0.063)。挪威患者的一年存活率相似,但五年存活率更高(58 (26.6%) vs 177 (18.2%),p = 0.005)。在多变量逻辑回归模型中,根据性别、吸烟史、表现状态、TNM分期和合并症等因素进行调整后,与丹麦相比,挪威患者5年存活的几率比为1.81(95% CI:1.11-2.94):我们发现,与丹麦患者相比,挪威患者中在潜在可治愈阶段确诊的比例更高,重度吸烟者更少。这可能是挪威NSCLC患者长期生存率较高的原因之一。