Abstract
Background: The role of histology in the targeted management of nonsmall cell lung cancer (NSCLC) has garnered renewed attention in recent years. We provide contemporary populationbased estimates of survival and an assessment of important prognostic factors in stage IV NSCLC by major histologic subtype. Methods: Using data from the Surveillance, Epidemiology and End Results (SEER) Program, we stratified 51,749 incident stage IV NSCLC patients (1988-2003 with follow-up through 2006) by major histologic subtype. We used Kaplan-Meier and Cox proportional hazards methods to describe overall survival and the prognostic influence of select patient, tumor, and treatment characteristics for each histologic subgroup. Results: Survival was highest in patients with bronchioloalveolar adenocarcinoma (1-year survival: 29.1%) and lowest in those with large cell tumors (1-year survival: 12.8%). Diagnosis in later years, female gender, younger age, either Asian/Pacific Islander or Hispanic race/ethnicity, lower tumor grade, and surgery or beam radiation as part of first-line treatment were generally independently associated with a decreased risk of death, but the prognostic significance of some of these factors (age, ethnicity, tumor grade) varied according to histologic subtype. Conclusion: Findings demonstrate a poor prognosis across histologic subtypes in stage IV NSCLC patients but highlight differences in both absolute survival and the relative importance of select prognostic factors by histologic subclassification. More research using other sources of population-based data could help clarify the role of histology in the presentation, management, and prognosis of late-stage NSCLC.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 139-148 |
| Number of pages | 10 |
| Journal | Clinical Epidemiology |
| Volume | 3 |
| Issue number | 1 |
| DOIs | |
| State | Published - 2011 |
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Keywords
- Epidemiology
- Histology
- Nonsmall cell lung cancer
- Survival
ASJC Scopus subject areas
- Epidemiology
Cite this
Survival by histologic subtype in stage IV nonsmall cell lung cancer based on data from the Surveillance, Epidemiology and end results program. / Cetin, Karynsa; Ettinger, David S; Hei, Yong jiang; O'Malley, Cynthia D.
In: Clinical Epidemiology, Vol. 3, No. 1, 2011, p. 139-148.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Survival by histologic subtype in stage IV nonsmall cell lung cancer based on data from the Surveillance, Epidemiology and end results program
AU - Cetin, Karynsa
AU - Ettinger, David S
AU - Hei, Yong jiang
AU - O'Malley, Cynthia D.
PY - 2011
Y1 - 2011
N2 - Background: The role of histology in the targeted management of nonsmall cell lung cancer (NSCLC) has garnered renewed attention in recent years. We provide contemporary populationbased estimates of survival and an assessment of important prognostic factors in stage IV NSCLC by major histologic subtype. Methods: Using data from the Surveillance, Epidemiology and End Results (SEER) Program, we stratified 51,749 incident stage IV NSCLC patients (1988-2003 with follow-up through 2006) by major histologic subtype. We used Kaplan-Meier and Cox proportional hazards methods to describe overall survival and the prognostic influence of select patient, tumor, and treatment characteristics for each histologic subgroup. Results: Survival was highest in patients with bronchioloalveolar adenocarcinoma (1-year survival: 29.1%) and lowest in those with large cell tumors (1-year survival: 12.8%). Diagnosis in later years, female gender, younger age, either Asian/Pacific Islander or Hispanic race/ethnicity, lower tumor grade, and surgery or beam radiation as part of first-line treatment were generally independently associated with a decreased risk of death, but the prognostic significance of some of these factors (age, ethnicity, tumor grade) varied according to histologic subtype. Conclusion: Findings demonstrate a poor prognosis across histologic subtypes in stage IV NSCLC patients but highlight differences in both absolute survival and the relative importance of select prognostic factors by histologic subclassification. More research using other sources of population-based data could help clarify the role of histology in the presentation, management, and prognosis of late-stage NSCLC.
AB - Background: The role of histology in the targeted management of nonsmall cell lung cancer (NSCLC) has garnered renewed attention in recent years. We provide contemporary populationbased estimates of survival and an assessment of important prognostic factors in stage IV NSCLC by major histologic subtype. Methods: Using data from the Surveillance, Epidemiology and End Results (SEER) Program, we stratified 51,749 incident stage IV NSCLC patients (1988-2003 with follow-up through 2006) by major histologic subtype. We used Kaplan-Meier and Cox proportional hazards methods to describe overall survival and the prognostic influence of select patient, tumor, and treatment characteristics for each histologic subgroup. Results: Survival was highest in patients with bronchioloalveolar adenocarcinoma (1-year survival: 29.1%) and lowest in those with large cell tumors (1-year survival: 12.8%). Diagnosis in later years, female gender, younger age, either Asian/Pacific Islander or Hispanic race/ethnicity, lower tumor grade, and surgery or beam radiation as part of first-line treatment were generally independently associated with a decreased risk of death, but the prognostic significance of some of these factors (age, ethnicity, tumor grade) varied according to histologic subtype. Conclusion: Findings demonstrate a poor prognosis across histologic subtypes in stage IV NSCLC patients but highlight differences in both absolute survival and the relative importance of select prognostic factors by histologic subclassification. More research using other sources of population-based data could help clarify the role of histology in the presentation, management, and prognosis of late-stage NSCLC.
KW - Epidemiology
KW - Histology
KW - Nonsmall cell lung cancer
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=79958075201&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79958075201&partnerID=8YFLogxK
U2 - 10.2147/CLEP.S17191
DO - 10.2147/CLEP.S17191
M3 - Article
C2 - 21607015
AN - SCOPUS:79958075201
VL - 3
SP - 139
EP - 148
JO - Clinical Epidemiology
JF - Clinical Epidemiology
SN - 1179-1349
IS - 1
ER -