title: Temporal trends from 1986 to 2008 in overall survival of small cell lung cancer patients.
abstract: OBJECTIVE
  An assessment of temporal trends in patient survival is important to determine the progress toward patient outcomes and to reveal where advancements must be made. This study assessed temporal changes spanning 22years in demographics, clinical characteristics, and overall survival of small cell lung cancer (SCLC) patients.
  
  
  METHODS
  This analysis included 1032 SCLC patients spanning two time-periods from the H. Lee Moffitt Cancer Center and Research Institute: 1986-1999 (N=410) and 2000-2008 (N=622). Kaplan-Meier survival curves and log-rank statistics were used to assess survival rates across the two time-periods and multivariable Cox proportional hazards models were used to generate hazard ratios (HRs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  The overall 5-year survival rate significantly increased from 8.3% for the 1986-1999 time-period to 11.0% (P<0.001) for the 2000-2008 time-period, and the median survival time increased from 11.3months (95% CI 10.5-12.7) to 15.2months (95% CI 13.6-16.6). We also observed significant increases in stage-specific median survival times and survival rates across the two time-periods. A multivariable Cox proportional hazards model for the entire cohort revealed significant increased risk of death for patients diagnosed in 1986-1999 (HR=1.29; 95% CI 1.11-1.49), patients diagnosed between 60 and 69years of age (HR=1.33; 95% CI 1.04-1.49) and over 70years of age (HR=1.63; 95% CI 1.26-2.11), men (HR=1.33; 95% CI 1.16-1.53), patients with no first course treatment (HR=2.17; 95% CI 1.57-3.00) and extensive stage SCLC (HR=2.79; 95% CI 2.35-3.30).
  
  
  CONCLUSIONS
  This analysis demonstrated significant improvements in overall and stage-specific median survival times and survival rates of SCLC patients treated at the Moffitt Cancer Center from 1986 to 2008.
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States. Electronic address: Matthew.Schabath@Moffitt.org.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Schabath
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States; University of South Florida, College of Public Health, Tampa, FL, United States.
authors.forename: Anthony
authors.initials: A
authors.lastname: Nguyen
authors.affiliation: University of South Florida, College of Public Health, Tampa, FL, United States.
authors.forename: Patrick
authors.initials: P
authors.lastname: Wilson
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States.
authors.forename: Katelyn R
authors.initials: KR
authors.lastname: Sommerer
authors.affiliation: Department of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States.
authors.forename: Zachary J
authors.initials: ZJ
authors.lastname: Thompson
authors.affiliation: Department of Thoracic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Chiappori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015897:Comorbidity; D005260:Female; D005431:Florida / Q000453:epidemiology; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000266:history / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012307:Risk Factors; D055752:Small Cell Lung Carcinoma / Q000453:epidemiology* / Q000266:history / Q000401:mortality; D062211:Spatio-Temporal Analysis; D016019:Survival Analysis
keywords: Cancer; Epidemiology; Lung cancer; Registry; Small cell lung cancer; Survival