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patients seen by our medical consultation (not all with patients were classifi ed into groups for comparison of
a diagnosis of lung cancer) were prospectively included their demographic and clinical characteristics as follows:
in our database registry. During the study period, our gender, stage and histology. The same classifi cation was
hospital served a predominantly rural community, with made for comparison of survival by year of diagnosis.
a population of about 210,000 in which geographic Statistical analysis was performed using SPSS 12.
mobility was low. Our lung cancer medical unit
treated and monitored patients by the same oncologist. Study approval
Candidates for surgery and radiotherapy were referred
to other hospitals for treatment, as our hospital does not The institution's ethical review board approved the
offer this specialty. study, and all patients provided written informed consent
and gave permission before study entry to collect their
From the records of patients who attended during clinical data for scientifi c purposes and publication.
the study period (2004-2014), the following
information was gathered: date of diagnosis, age Results
at appointment, gender and tumor histology (2004
[8]
WHO classifi cation). Immunohistochemical markers From January 1, 2004 to June 15, 2014, 701 patients were
(CK7, CK20, TTF-1 and p63) have been used at our included at our series. Patients’ characteristics are shown
hospital since 2007. [9-11] Tumor-node-metastasis ( TNM) in Table 1. We found an aged and male-predominant
stage by American Joint Committee on Cancer, Seventh population (mean age: 67.6; 91.4% were male).
[12]
Edition, was also utilized. Patients with non-small
cell lung cancer (NSCLC) were classifi ed by clinical
parameters (clinical TNM), with small cell lung Table 1: Patient characteristics (n = 701)
cancer (SCLC) also being classifi ed by TNM system. Characteristics n (%)
Dates of death were included, although when the date Gender
was undefi ned based on records, family was contacted. Men 642 (91.6)
We reported the cause of death (death without disease; Women 59 (8.4)
death with the disease). For patients still alive, the last Age, years
follow-up was recorded as July 15, 2014. Survival time Mean, range 67.6 (34-94)
was calculated from the time of histological/radiological Median 69
diagnosis. Patients had to have at least 1-month of Mode 70
follow-up. Histology
Unconfi rmed 24 (3.4)
Genetic testing, when performed, was for the epidermal Small cell 120 (17.1)
growth factor receptor (EGFR) and other NSCLC-driving Non-small cell 556 (79.4)
mutations. Screening for drug-sensitive EGFR mutations Squamous 291 (41.5)
was conducted as part of a clinical assistance program, Adenocarcinoma 187 (26.7)
since June 2010, by peptide nucleic acid-locked nucleic Bronchoalveolar 1 (0.1)
acid polymerase chain reaction clamp-based testing. Large cell carcinoma 43 (6.1)
Those who were not analyzed have been recorded as Carcinoma not typed 15 (2.1)
“not determined.” Anaplastic lymphoma kinase (ALK) Sarcoma-squamous (carcinosarcoma) 3 (0.4)
translocations were determined via fl uorescence in situ Neuroendocrine tumors 11 (1.6)
hybridization since June 2012. We did not study K-RAS Mesothelioma 6 (0.9)
mutations as part of the standard of care. Other aspects Stage at diagnosis
relevant to prognosis, such as the Eastern Cooperative 0 1 (0.1)
Oncology Group score, treatment type, weight loss and I 71 (10.1)
smoking habits, were not recorded. II 53 (7.6)
III 171 (24.4)
Statistical analysis IV 405 (57.8)
Results were expressed as means (standard deviation) and Survival (months)
percentages. The relationships between different variables Mean, range 25.58 (22.1-29)
were evaluated. Statistics of contrasts, such as Chi-square, Median 11
Mann-Whitney U-test or Kruskal-Wallis H-test, were Situation at last follow-up (July 15, 2014)
used for comparisons of two variables. Estimations are Alive without disease 42 (6)
accompanied by 95% confi dence intervals. Statistical Alive with disease 115 (16.4)
signifi cance was set at a value of P < 0.05. Survival Death without disease 23 (3.3)
time was defi ned as the period from the date of fi rst Death with disease 521 (74.3)
visit to the date of mortality or last follow-up. Survival Situation at last follow-up (July 15, 2014)
date was updated on July 15, 2014. In addition to the Alive 157 (22.4)
estimation of the survival rates by Kaplan-Meier method, Death 544 (77.6)
202 Journal of Cancer Metastasis and Treatment ¦ Volume 1 ¦ Issue 3 ¦ October 15, 2015 ¦