A 30-year evaluation of the surgical outcomes for non-small cell lung cancer
Research published in the June edition of the Journal of Thoracic Oncology sought to investigate the time trends of surgical outcomes of patients with non-small cell lung cancer (NSCLC) between 1979 and 2008. The incidence of lung cancer continues to rise; therefore, countermeasures to decrease death rates have become an important public health issue. After analyzing the time trends, researchers postulated that the increase of patients diagnosed with early stages of adenocarcinoma contribute to the favorable prognostic and survival outcomes. Furthermore, the research highlights that prognosis of NSCLC patients has improved in recent years.
The current treatment strategy for NSCLC depends on clinical staging, to which surgical resection is the first-line treatment for stages I to II. Moreover, only a few of the stage III cases are treated surgically. While the standards for surgical treatment have remained unchanged for a few decades, there have been a number of advances in perioperative, anesthetic, and intraoperative management, specifically over the past three decades. To gather insights on the correlation to overall survival, the present study retrospectively investigated the clinicopathologic features of NSCLC patients who underwent surgery and the corresponding time trends of surgical outcomes.
To draw the analysis, researchers reviewed records of nearly 1,500 patients who underwent resection of NSCLC during the following five time intervals: (1) 1979 - 1988, (2) 1989 - 1993, (3) 1994 - 1998, (4) 1999� and (5) 2004�. Overall results showed that the number of patients who underwent a resection, the percentage of pathologic stage IA lung cancers, their subsequent survival and the percentage of adenocarcinoma have all progressively increased over the almost 30 year span. The only variable that decreased was tumor size, indicating that diagnoses were increasingly earlier. Most notably survival rates for 1999-2004 and 2004-2008 were significantly better than any of the previous three periods.
"The prognosis of NSCLC patients has been remarkably improved in recent years," explains lead study investigator Takeshi Hanagiri, MD, PhD. "The increase of patients with diagnosed with adenocarcinoma in the early stages is thought to strongly contribute to the favorable results, further reiterating the key factor of early diagnosis for improving the survival of lung cancer patients after surgical treatment. Thus, early diagnosis remains a key factor for improving the survival of lung cancer patients after surgical treatment"