Do evolving practices improve survival in operated lung cancer patients? A biobank may answer.
BACKGROUND
Biobanks may play a pivotal role in lung cancer patients' management, research, and health policy. The Nancy "Centre of Biologic Resources" analyzed the evolving profiles of operated lung cancer patients and their management over 20 years.


METHODS
A total of 1259 consecutive patients operated upon from 1988 till 2007 were included. Survival rates were statistically compared before and after 1997. The parameters associated with a significant improvement of survival were determined.


RESULTS
After 1997, lung cancer was diagnosed at an earlier stage. For Squamous Cell Lung Cancer (SQCLC), stages IA increased from 5.4 to 19.5% and for Adenocarcinoma (ADC), stage IA increased from 9.9 to 24.7%. More women with stage I ADC were operated upon after 1997 (p = 0.01). More patients with Large Cell Lung Cancer were diagnosed recently. Recent patients received more adjuvant or neo-adjuvant chemotherapy (p < 0.001) and less radiotherapy (stage I SQCLC: p = 0.019, stage I ADC: p < 0.001). A longer overall patients' survival was observed after 1997 (chi test for SQLC and ADC independently p < or = 0.002). Among SQCLC long survivors, those at stage I-II, below 50 years, were more numerous. A longer survival was associated with early stage in ADC patients. Stage was the single constant factor for overall outcome.


CONCLUSIONS
Overall and stage-adjusted survival of operated lung cancer patients has been improved in the last decade due mainly to earlier diagnosis. The generalized use of computed tomography scan, chemotherapy, and a collegial management improved patients' survival.
Vlastos
Fotis
F
Centre of Biological Resources/U 724 INSERM, Central Hospital, Cour d'Anatomie, Rue Lionnois, Nancy, France. fovlastos@yahoo.gr
Lacomme
Stéphanie
S
Wild
Pascal
P
Poulain
Stéphane
S
Siat
Joëlle
J
Grosdidier
Gilles
G
du Manoir
Stanislas
S
Monga
Ben
B
Hillas
Georgios
G
Varsovie
Roselyne
R
Claudot
Frédérique
F
Marie
Béatrice
B
Vignaud
Jean Michel
JM
Szymanski
Nadine
N
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D012737:Sex Factors