TY - JOUR
T1 - Progress in standard of care therapy and modest survival benefits in the treatment of non-small cell lung cancer patients in the Netherlands in the last 20 years
AU - Van Der Drift, Miep A.
AU - Karim-Kos, Henrike E.
AU - Siesling, Sabine
AU - Groen, Harry J.M.
AU - Wouters, Michel W.J.M.
AU - Coebergh, Jan Willem
AU - De Vries, Esther
AU - Janssen-Heijnen, Maryska L.G.
PY - 2012/2
Y1 - 2012/2
N2 - Introduction: Lung cancer is the leading cause of cancer mortality worldwide. We analyzed changes in treatment and their potential effect on survival of non-small cell lung cancer (NSCLC) patients in the Netherlands. Methods: All NSCLC patients diagnosed during 1989-2009 (n = 147,760) were selected from the population-based Netherlands Cancer Registry. Differences in treatment over time were tested by the Cochran-Armitage trend test. The effects of sex, age, histology, and treatment on relative survival were estimated in multivariable models. Follow-up was completed until January 1, 2010. Results: Between 1989 and 2009, the proportion of younger patients (younger than 75 years) with stage I undergoing surgery increased from 84 to 89% and among elderly (75 years or elder) from 35 to 49%; for stage II, this proportion decreased from 80 to 70% and remained about 25% in respectively younger and older patients. Adjuvant chemotherapy for stage II increased to from 0 to 24% in younger patients but remained less than 5% among the elderly. Chemoradiation increased from 8 to 43% among younger patients with stage III and from 1 to 13% among elderly. In stage IV, chemotherapy in younger patients increased from 10 to 54% and in elderly from 5 to 21%. Five-year relative survival of the total group increased from 14.8 to 17% (especially among females, younger patients, and within each stage), which could be partly explained by changes in treatment and better staging. Conclusions: Over a 20-year period, application of therapy, which is currently considered as standard, has improved. This resulted in small improvements in survival within all stages.
AB - Introduction: Lung cancer is the leading cause of cancer mortality worldwide. We analyzed changes in treatment and their potential effect on survival of non-small cell lung cancer (NSCLC) patients in the Netherlands. Methods: All NSCLC patients diagnosed during 1989-2009 (n = 147,760) were selected from the population-based Netherlands Cancer Registry. Differences in treatment over time were tested by the Cochran-Armitage trend test. The effects of sex, age, histology, and treatment on relative survival were estimated in multivariable models. Follow-up was completed until January 1, 2010. Results: Between 1989 and 2009, the proportion of younger patients (younger than 75 years) with stage I undergoing surgery increased from 84 to 89% and among elderly (75 years or elder) from 35 to 49%; for stage II, this proportion decreased from 80 to 70% and remained about 25% in respectively younger and older patients. Adjuvant chemotherapy for stage II increased to from 0 to 24% in younger patients but remained less than 5% among the elderly. Chemoradiation increased from 8 to 43% among younger patients with stage III and from 1 to 13% among elderly. In stage IV, chemotherapy in younger patients increased from 10 to 54% and in elderly from 5 to 21%. Five-year relative survival of the total group increased from 14.8 to 17% (especially among females, younger patients, and within each stage), which could be partly explained by changes in treatment and better staging. Conclusions: Over a 20-year period, application of therapy, which is currently considered as standard, has improved. This resulted in small improvements in survival within all stages.
KW - Non-small cell lung cancer
KW - Population-based
KW - Survival
KW - Treatment
KW - Trends
UR - http://www.scopus.com/inward/record.url?scp=84858310285&partnerID=8YFLogxK
U2 - 10.1097/JTO.0b013e31823a01fb
DO - 10.1097/JTO.0b013e31823a01fb
M3 - Article
AN - SCOPUS:84858310285
SN - 1556-0864
VL - 7
SP - 291
EP - 298
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 2
ER -