Determinants of long term survival after surgery for cancer of the lung
A population-based study
Article first published online: 20 NOV 2000
Copyright © 1999 American Cancer Society
Volume 86, Issue 11, pages 2229–2237, 1 December 1999
How to Cite
Bouchardy, C., Fioretta, G., De Perrot, M., Obradovic, M. and Spiliopoulos, A. (1999), Determinants of long term survival after surgery for cancer of the lung. Cancer, 86: 2229–2237. doi: 10.1002/(SICI)1097-0142(19991201)86:11<2229::AID-CNCR9>3.0.CO;2-K
- Issue published online: 20 NOV 2000
- Article first published online: 20 NOV 2000
- Manuscript Accepted: 13 JUL 1999
- Manuscript Revised: 11 JUN 1999
- Manuscript Received: 14 JAN 1999
- lung carcinoma;
- long term survival;
- prognostic factors;
- cancer registry
Even if some determinants of lung cancer (LC) prognosis have been established, their independent effect on long term survival remains to be seen. The objective of the current study was to identify the prognostic indicators of long term survival among LC patients treated by surgery.
All patients with LC recorded at the Geneva Cancer Registry between 1977 and 1987 were analyzed by logistic regression, considering as cases (n = 98) those patients alive 10 years after their initial diagnosis and as controls (n = 330) all other patients, excluding those who did not undergo putative curative surgery. The effect of each prognostic factor was evaluated after accounting for age and gender (“crude” effect) and also for other a priori confounding factors (adjusted effect). Additional models considered two staging variables simultaneously to identify the strongest staging determinant. Results were presented as relative risk estimates of long term (≥10 years) survival.
Age, histology, and stage of disease significantly influenced prognosis regardless of the confounding factors considered. Gender also emerged as a discriminated factor in LC outcome, with a 2.1-fold increased chance (95% confidence interval, 1.6–3.5) of long term survival for women compared with men. Method of discovery, presence of symptoms, period of diagnosis, socioeconomic status, and tumor differentiation did not appear to be associated with long term survival. Extent and size of the tumor were found to be the most reliable prognostic staging factors, whereas adenopathy had no effect after accounting for extension.
The current population-based study quantifies the independent effect of the factors modifying the chances of curability in patients with LC. In particular, it provides additional evidence that gender strongly influences long term survival. Cancer 1999;86:2229–37. © 1999 American Cancer Society.