A time trend of profile and surgical results in 1123 patients with non-small cell lung cancer.
BACKGROUND
A time trend for characteristics and prognoses of patients with non-small cell lung cancer (NSCLC) who underwent surgical resection was investigated.


METHODS
A series of 1123 consecutive patients with NSCLC who underwent surgical resection from 1975 to 1998 was reviewed with respect to changes in patient profile and surgical outcome among subgroups classified by clinicopathologic factors.


RESULTS
With time, the proportion of female, elderly (> or =70 years), pathologic stage IA, nonsmoking, and adenocarcinoma patients increased significantly whereas pneumonectomy, incomplete resection, and pathologic stage IIIA patients decreased significantly. Overall survival showed an upward trend with 5-year survival rates of 30.0% in the 1970s, 41.6% in the 1980s, and 50.1% in the 1990s (P <.0001). This tendency was similar in every pathologic stage that was observed. The proportion of female patients with adenocarcinoma that exhibited the most favorable prognosis among subpopulations classified by gender and cell types was significantly higher in the 1990s (28.0%) than in the 1970s (14.0%). Multivariate analysis revealed that female gender, adenocarcinoma, complete resection, and early pathologic stage were independently favorable factors whereas advanced age was an unfavorable factor.


CONCLUSIONS
The improved survival following surgical resection for NSCLC during the study period was associated with an increasing population of female patients with adenocarcinoma, more detection of early disease, and effective elimination of unresectable cases.
Yoshino
Ichiro
I
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Baba
Hiromitsu
H
Fukuyama
Seiichi
S
Kameyama
Toshifumi
T
Shikada
Yasunori
Y
Tomiyasu
Makiko
M
Suemitsu
Ryuichi
R
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D013514:Surgical Procedures, Operative / Q000639:trends; D016019:Survival Analysis