Abstract
Background: Population-based estimates of absolute risk of lung cancer recurrence, and of mortality rates after recurrence, can inform clinical management. Methods: We evaluated prognostic factors for recurrences and survival in 2098 lung cancer case patients from the general population of Lombardy, Italy, from 2002 to 2005. We conducted survival analyses and estimated absolute risks separately for stage IA to IIIA surgically treated and stage IIIB to IV non-surgically treated patients. Results: Absolute risk of metastases exceeded that of local recurrence in every stage and cell type, highlighting the systemic threat of lung cancer. In stage I, the probability of dying within the first year after diagnosis was 2.7%, but it was 48.3% within first year after recurrence; in stage IV, the probabilities were 57.3% and 80.6%, respectively. Over half the patients died within one year of first metastasis. Although in stages IA to IB about one-third of patients had a recurrence, stage IIA patients had a recurrence risk (61.2%) similar to stage IIB (57.9%) and IIIA (62.8%) patients. Risk of brain metastases in stage IA to IIIA surgically treated non-small cell lung cancer patients increased with increasing tumor grade. Absolute risk of recurrence was virtually identical in adenocarcinoma and squamous cell carcinoma patients. Conclusions: This population-based study provides clinically useful estimates of risks of lung cancer recurrence and mortality that are applicable to the general population. These data highlight the need for more effective adjuvant treatments overall and within specific subgroups. The estimated risks of various endpoints are useful for designing clinical trials, whose power depends on absolute numbers of events.
| Original language | English |
|---|---|
| Article number | djv059 |
| Journal | Journal of the National Cancer Institute |
| Volume | 107 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 1 2015 |
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ASJC Scopus subject areas
- Cancer Research
- Oncology
- Medicine(all)
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Lung cancer prognosis before and after recurrence in a population-based setting. / Consonni, Dario; Pierobon, Mariaelena; Gail, Mitchell H.; Rubagotti, Maurizia; Rotunno, Melissa; Goldstein, Alisa; Goldin, Lynn; Lubin, Jay; Wacholder, Sholom; Caporaso, Neil E.; Bertazzi, Pier Alberto; Tucker, Margaret A.; Pesatori, Angela C.; Landi, Maria Teresa.
In: Journal of the National Cancer Institute, Vol. 107, No. 6, djv059, 01.06.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Lung cancer prognosis before and after recurrence in a population-based setting
AU - Consonni, Dario
AU - Pierobon, Mariaelena
AU - Gail, Mitchell H.
AU - Rubagotti, Maurizia
AU - Rotunno, Melissa
AU - Goldstein, Alisa
AU - Goldin, Lynn
AU - Lubin, Jay
AU - Wacholder, Sholom
AU - Caporaso, Neil E.
AU - Bertazzi, Pier Alberto
AU - Tucker, Margaret A.
AU - Pesatori, Angela C.
AU - Landi, Maria Teresa
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background: Population-based estimates of absolute risk of lung cancer recurrence, and of mortality rates after recurrence, can inform clinical management. Methods: We evaluated prognostic factors for recurrences and survival in 2098 lung cancer case patients from the general population of Lombardy, Italy, from 2002 to 2005. We conducted survival analyses and estimated absolute risks separately for stage IA to IIIA surgically treated and stage IIIB to IV non-surgically treated patients. Results: Absolute risk of metastases exceeded that of local recurrence in every stage and cell type, highlighting the systemic threat of lung cancer. In stage I, the probability of dying within the first year after diagnosis was 2.7%, but it was 48.3% within first year after recurrence; in stage IV, the probabilities were 57.3% and 80.6%, respectively. Over half the patients died within one year of first metastasis. Although in stages IA to IB about one-third of patients had a recurrence, stage IIA patients had a recurrence risk (61.2%) similar to stage IIB (57.9%) and IIIA (62.8%) patients. Risk of brain metastases in stage IA to IIIA surgically treated non-small cell lung cancer patients increased with increasing tumor grade. Absolute risk of recurrence was virtually identical in adenocarcinoma and squamous cell carcinoma patients. Conclusions: This population-based study provides clinically useful estimates of risks of lung cancer recurrence and mortality that are applicable to the general population. These data highlight the need for more effective adjuvant treatments overall and within specific subgroups. The estimated risks of various endpoints are useful for designing clinical trials, whose power depends on absolute numbers of events.
AB - Background: Population-based estimates of absolute risk of lung cancer recurrence, and of mortality rates after recurrence, can inform clinical management. Methods: We evaluated prognostic factors for recurrences and survival in 2098 lung cancer case patients from the general population of Lombardy, Italy, from 2002 to 2005. We conducted survival analyses and estimated absolute risks separately for stage IA to IIIA surgically treated and stage IIIB to IV non-surgically treated patients. Results: Absolute risk of metastases exceeded that of local recurrence in every stage and cell type, highlighting the systemic threat of lung cancer. In stage I, the probability of dying within the first year after diagnosis was 2.7%, but it was 48.3% within first year after recurrence; in stage IV, the probabilities were 57.3% and 80.6%, respectively. Over half the patients died within one year of first metastasis. Although in stages IA to IB about one-third of patients had a recurrence, stage IIA patients had a recurrence risk (61.2%) similar to stage IIB (57.9%) and IIIA (62.8%) patients. Risk of brain metastases in stage IA to IIIA surgically treated non-small cell lung cancer patients increased with increasing tumor grade. Absolute risk of recurrence was virtually identical in adenocarcinoma and squamous cell carcinoma patients. Conclusions: This population-based study provides clinically useful estimates of risks of lung cancer recurrence and mortality that are applicable to the general population. These data highlight the need for more effective adjuvant treatments overall and within specific subgroups. The estimated risks of various endpoints are useful for designing clinical trials, whose power depends on absolute numbers of events.
UR - http://www.scopus.com/inward/record.url?scp=84930705828&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84930705828&partnerID=8YFLogxK
U2 - 10.1093/jnci/djv059
DO - 10.1093/jnci/djv059
M3 - Article
C2 - 25802059
AN - SCOPUS:84930705828
VL - 107
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
SN - 0027-8874
IS - 6
M1 - djv059
ER -