Lung cancer survival trends and prognostic factors: A 26-year population-based study in Girona Province, Spain

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2024-10-20 DOI:10.1016/j.lungcan.2024.107995

Eduard Teixidor-Vilà , Jan Trallero , Montse Puigdemont , Anna Vidal-Vila , Alejandro Hernandez-Martínez , Elia Sais , Josep Sabaté-Ortega , Sara Verdura , Javier A. Menendez , Joaquim Bosch-Barrera , Arantza Sanvisens , Rafael Marcos-Gragera

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Abstract

Background

Lung cancer (LC) is Europe’s primary cause of cancer-related mortality largely due to its historically low survival rates. The aim of this study was to analyze 26-year survival trends in the province of Girona, Spain, and to identify key prognostic factors.

Methods

Population-based study of LC cases collected between 1994 and 2019, with follow-up until December 31, 2021. Variables included date of diagnosis, sex, age, histology, and tumor stage (the latter since 2010). Diagnosis dates were categorized into three periods (1994–2002, 2003–2011, and 2012–2019). Multivariate flexible parametric models, incorporating age as a non-linear, time-varying covariate, were used to analyze net survival (NS) and trends. Annual absolute change in survival (AAC_S) was calculated using 3-year NS.

Results

The analysis of 9,113 LC cases showed a NS improvement between the first and last period (7.1 months (95 %CI: 6.5;7.6) to 8.5 months (95 %CI: 7.9;9.1)). Squamous cell carcinoma (NSC-SCC) showed the greatest improvement with an AAC_S of 0.32 % (95 % CI: 0.21; 0.43), while survival for non-small cell lung cancer not otherwise specified declined (AAC_S of −0.19 % (95 %CI: −0.26; −0.12)). Prognostic analysis of the 3,642 cases (2010–2019) indicated a lower LC death risk for adenocarcinoma and NSC-SCC compared to LC not otherwise specified (HR 0.52 and 0.62, respectively). Increasing tumor stage correlated with higher LC mortality risk (1.8-, 4.0-, and 10.1-fold increase for stage II, III, and IV, respectively, compared to stage I).

Conclusions

LC survival has notably improved, particularly for NSC-SCC. Survival is influenced by sex, age, date of diagnosis, tumor histology and especially by stage, underscoring comprehensive data collection’s importance.

查看原文本刊更多论文

肺癌的生存趋势和预后因素：西班牙赫罗纳省一项为期 26 年的人口研究。

背景：肺癌（LC）是欧洲癌症相关死亡的主要原因，这主要是因为肺癌的存活率历来较低。本研究旨在分析西班牙赫罗纳省 26 年的生存趋势，并确定关键的预后因素：方法：对 1994 年至 2019 年间收集的 LC 病例进行基于人口的研究，随访至 2021 年 12 月 31 日。变量包括诊断日期、性别、年龄、组织学和肿瘤分期（后者自 2010 年起）。诊断日期分为三个时期（1994-2002 年、2003-2011 年和 2012-2019 年）。多变量灵活参数模型将年龄作为非线性时变协变量，用于分析净生存率（NS）和趋势。每年生存率的绝对变化（AAC_S）以3年净生存率计算：结果：对 9113 例 LC 病例的分析表明，NS 在第一阶段和最后阶段之间有所改善（7.1 个月（95 %CI：6.5;7.6）至 8.5 个月（95 %CI：7.9;9.1））。鳞状细胞癌（NSC-SCC）的生存期改善幅度最大，AAC_S 为 0.32 % (95 %CI: 0.21; 0.43)，而未作其他说明的非小细胞肺癌的生存期则有所下降（AAC_S 为 -0.19 % (95 %CI: -0.26; -0.12)）。对 3,642 例病例（2010-2019 年）进行的预后分析表明，腺癌和非小细胞肺癌的 LC 死亡风险低于非特异性 LC（HR 分别为 0.52 和 0.62）。肿瘤分期的增加与LC死亡风险的增加相关（与I期相比，II期、III期和IV期的LC死亡风险分别增加了1.8倍、4.0倍和10.1倍）：结论：LC 的生存率显著提高，尤其是 NSC-SCC 的生存率。生存率受性别、年龄、诊断日期、肿瘤组织学，尤其是分期的影响，这凸显了全面数据收集的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.