title: Conditional cancer-specific versus cardiovascular-specific survival after lobectomy for stage I non-small cell lung cancer.
abstract: BACKGROUND
  Conditional cancer-specific survival rates account for changes in the risk of death from cancer over time. There may be a point during follow-up when patients who undergo lobectomy for stage I non-small cell lung cancer (NSCLC) are as likely to die of cardiovascular disease as of cancer.
  
  
  METHODS
  Using the Surveillance Epidemiology and End Results Database (1988 through 2005), we identified patients 50 years old and older who underwent lobectomy for stage I NSCLC. We used competing risks methods to calculate conditional survival rates and to ascertain if there is a point in follow-up where the risk of dying of cancer is equivalent to the risk of dying of cardiovascular disease.
  
  
  RESULTS
  In all, 22,518 patients met our inclusion criteria. The difference in the 5-year conditional probability of dying of cancer and the 5-year conditional probability of dying of cardiovascular disease decreased with time; in the whole cohort, these probabilities were equivalent if patients survived to 7 years after lobectomy (p = 0.11). With increasing age, the probability of dying of cancer and the probability of dying of cardiovascular disease became equivalent at earlier time points. Furthermore, the 5-year probability of dying of cardiovascular disease was significantly greater than the 5-year probability of dying of cancer for patients aged 70 to 79 years who survived to 7 years and for patients aged 80 years and older who survived to 5 years after lobectomy.
  
  
  CONCLUSIONS
  For patients undergoing lobectomy for stage I NSCLC, cardiovascular-specific mortality becomes increasingly important over the course of follow-up, especially among elderly patients.
authors.affiliation: Division of General Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
authors.forename: Shawn S
authors.initials: SS
authors.lastname: Groth
authors.forename: Natasha M
authors.initials: NM
authors.lastname: Rueth
authors.forename: James S
authors.initials: JS
authors.lastname: Hodges
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Habermann
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Andrade
authors.forename: Jonathan
authors.initials: J
authors.lastname: D'Cunha
authors.forename: Michael A
authors.initials: MA
authors.lastname: Maddaus
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000401:mortality*; D015996:Survival Rate