Prognostic Factors and Overall Survival of Advanced Stage NSCLC Patients in Saraburi Hospital
Keywords:
Non-small cell lung cancer, Advanced stage, SurvivalAbstract
Background : Incidence and mortality of lung cancer are increasing. However, factors associating with survival is limited.
Objectives : This study aimed to analyze prognostic factors and overall survival of patients who were diagnosed and treated at Saraburi Hospital.
Methods : All 205 patients diagnosed with non-small cell lung cancer (NSCLC) stage 4 were recruited between 1st January 2013 and 31st December 2018. This retrospectively collected cohort was investigated about factors indicating prognosis and overall survival using Cox proportional hazard model.
Results : Patients who were treated with an appropriated treatment having better survival three times over than those who were not. Delay interval time between first contact with a doctor and oncologists increased risk of mortality with a hazard ratio (HR) 1.02 (95% CI = 1.002, 1.030). Patients who were frail (ECOG 3-4) increased risk of death, compared to those who were well performance [HR 2.29 (95% CI = 1.31, 4.01)]. Also, a personal history of smoking associated with a higher risk of death than non-smokers [HR 3.01 (95% CI = 1.63, 5.53)]. The 1-yr overall survival (OS) reached 76.6% (95% CI = 68.8, 82.6) when patients received specific treatments. Compared to chemotherapy and best supportive care, targeted therapy provided best survival rate with 1-yr OS at 100% and 5-yr OS at 58%. Treatment with chemotherapy gave second best survival rates (1-yr OS 76.9% and 5-yr OS 26.2%).
Conclusions : Patients who received specific treatments gained better outcomes than those who did not. Prolonged waiting time to visiting an oncologist could have lessen survival. Poor performance status and history of smoking increased risk of death. Although, there were a limited number of patients who were treated with targeted therapy, the survival rate was the best compared to other treatments
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