Lung cancer prognosis before and after recurrence in a population-based setting

Dario Consonni, Mariaelena Pierobon, Mitchell H. Gail, Maurizia Rubagotti, Melissa Rotunno, Alisa Goldstein, Lynn Goldin, Jay Lubin, Sholom Wacholder, Neil E. Caporaso, Pier Alberto Bertazzi, Margaret A. Tucker, Angela C. Pesatori, Maria Teresa Landi

Research output: Contribution to journalArticle

28 Citations (Scopus)

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 languageEnglish
Article numberdjv059
JournalJournal of the National Cancer Institute
Volume107
Issue number6
DOIs
Publication statusPublished - Jun 1 2015

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Lung Neoplasms
Recurrence
Population
Neoplasm Metastasis
Mortality
Survival Analysis
Non-Small Cell Lung Carcinoma
Italy
Squamous Cell Carcinoma
Adenocarcinoma
Clinical Trials
Survival
Brain
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Consonni, D., Pierobon, M., Gail, M. H., Rubagotti, M., Rotunno, M., Goldstein, A., ... Landi, M. T. (2015). Lung cancer prognosis before and after recurrence in a population-based setting. Journal of the National Cancer Institute, 107(6), [djv059]. https://doi.org/10.1093/jnci/djv059

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 journalArticle

Consonni, D, Pierobon, M, Gail, MH, Rubagotti, M, Rotunno, M, Goldstein, A, Goldin, L, Lubin, J, Wacholder, S, Caporaso, NE, Bertazzi, PA, Tucker, MA, Pesatori, AC & Landi, MT 2015, 'Lung cancer prognosis before and after recurrence in a population-based setting', Journal of the National Cancer Institute, vol. 107, no. 6, djv059. https://doi.org/10.1093/jnci/djv059
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. / Lung cancer prognosis before and after recurrence in a population-based setting. In: Journal of the National Cancer Institute. 2015 ; Vol. 107, No. 6.
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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.",
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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

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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.

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