Temporal trends from 1986 to 2008 in overall survival of small cell lung cancer patients
Menée aux Etats-Unis auprès de 1 032 patients atteints d'un cancer du poumon à petites cellules, cette étude analyse l'évolution de la survie globale sur la période 1986-2008
Objectives : An assessment of temporal trends in patient survival is important to determine the progress towards patient outcomes and to reveal where advancements must be made. This study assessed temporal changes spanning 22 years in demographics, clinical characteristics, and overall survival of small cell lung cancer (SCLC) patients. Materials and methods : This analysis included 1,032 SCLC patients spanning two time-periods from the H. Lee Moffitt Cancer Center and Research Institute: 1986 to 1999 (No. = 410) and 2000 to 2008 (No. = 622). Kaplan-Meier survival curves and log-rank statistics were used to assess survival rates across the two time-periods and multivariable Cox proportional hazards models were used to generate hazard ratios (HRs) and 95% confidence intervals (CIs). Results : The overall 5-year survival rate significantly increased from 8.3% for the 1986 to 1999 time-period to 11.0% (P < 0.001) for the 2000 to 2008 time-period, and the median survival time increased from 11.3 months (95% CI 10.5–12.7) to 15.2 months (95% CI 13.6–16.6) We also observed significant increases in stage-specific median survival times and survival rates across the two time-periods. A multivariable Cox proportional hazards model for the entire cohort revealed significant increased risk of death for patients diagnosed in 1986 to 1999 (HR = 1.29; 95% CI 1.11–1.49), patients diagnosed between 60 and 69 years of age (HR = 1.33; 95% CI 1.04–1.49) and over 70 years of age (HR = 1.63; 95% CI 1.26–2.11), men (HR = 1.33; 95% CI 1.16–1.53), patients with no first course treatment (HR = 2.17; 95% CI–3.00) and extensive stage SCLC (HR = 2.79; 95% CI 2.35–3.30). Conclusion : This analysis demonstrated significant improvements in overall and stage-specific median survival times and survival rates of SCLC patients treated at the Moffitt Cancer Center from 1986 to 2008.
Lung Cancer 2014