Overall survival and prognostic factors in Stage I lung adenocarcinoma treated with curative intent: A real‐life 19‐year cohort study

• Published in: Journal of surgical oncology Vol. 126; no. 6; pp. 1114 - 1122
• Main Authors: Abrão, Fernando Conrado, Abreu, Igor Renato Louro Bruno, Silva, Vinícius Guimarães, Rosamilia, Gabriel de Andrade, Peres, Stela Verzinhasse, Hanriot, Rodrigo de Morais, Younes, Riad Naim
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc 01-11-2022
• Subjects: cancer treatment; Cohort analysis; curative intent; Lung cancer; Medical diagnosis; Medical prognosis; prognostic factors; Stage I lung cancer
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.27015

Objectives
Important differences in Stage I non–small‐cell lung cancer (NSCLC) are related to the delay in the diagnosis to the treatment, hospitals' specialised status, comorbidities, tumour stage and histological type.
Methods
A 19‐year retrospective cohort study was conducted, including 681 patients with NSCLC in clinical‐stage IA–IB. The variables analysed were gender, age, schooling, type of health care provider, type of treatment, period of 5‐year treatment, the time between first attendance to diagnosis and the time between diagnosis and treatment, and hospital's specialised status.
Results
Patients who underwent radiotherapy alone had three times more risk of death than those who underwent surgery alone (adjusted hazard ratio [adjHR] = 3.44; 95% confidence interval [CI]: 2.45–4.82; p <0.001). The independent risk of death factors was being treated in nonhigh complexity centres in oncology hospitals and having started the treatment more than 2 months after diagnosis (adjHR = 1.80; 95% CI: 1.26–2.56; p <0.001) and (adjHR = 2.00; 95% CI: 1.33–3.00; p <0.001), respectively. In addition, the patients diagnosed between 2011 and 2015 had a 40% lower risk of death when compared to those diagnosed between 2000 and 2005 (95% CI: 0.38–0.94; p = 0.027).
Conclusion
The overall survival in curative intent Stage‐I lung cancer patients' treatment was associated with the 5‐year diagnosis group, the delayed time between diagnosis and treatment and the hospital qualification.