title: Longitudinal analysis of 2293 NSCLC patients: a comprehensive study from the TYROL registry.
abstract: BACKGROUND
  The aim of this study was to describe a large consecutive cohort of non-small cell lung cancer (NSCLC) patients treated in daily routine within the last 25 years. An extensive list of general baseline characteristics (comorbidities, laboratory values, symptoms, performance state), NSCLC related factors (stage, histology), treatment related parameters (approach, applied therapies) and outcome (PFS, RFS, OS, perspective of decades) were analyzed in detail.
  
  
  METHODS
  Medical files of 2293 consecutive NSCLC patients diagnosed between 1989 and 2009 at the Medical University of Innsbruck and affiliated hospitals were retrospectively analyzed. Patients were documented within our institution's comprehensive lung cancer project "Twenty-Year Retrospective of Lung Cancer (TYROL study)".
  
  
  RESULTS
  Mean age at diagnosis was 64.1 years and 1611 patients (70.3%) were male. Most patients were diagnosed in stage IV (37.9%). The most frequent comorbidities present at diagnosis were cardiovascular disease (62.1%) and COPD (62.0%). The most common symptoms at diagnosis were coughing (54.7%) and dyspnea (45.3%). Of all 2293 patients 1981 (86.4%) received adequate antineoplastic treatment. In total 874 patients were radically operated, 119 received radiotherapy/radio-chemotherapy and the majority of patients (n=1278) were treated in palliative intent. A 2nd, 3rd, 4th and 5th-line palliative therapy was administered to 612, 278, 102, and 36 patients. Median OS, RFS and PFS were 16.4 months, 86.4 months and 5.1 months, respectively. A multitude of factors was associated with all three outcome variables. Of note, outcome has improved stepwise in the recent decade based on increased response rates leading to prolonged OS.
  
  
  CONCLUSIONS
  This work incorporates most clinical aspects relevant in the treatment of NSCLC and beyond. Therefore, this comprehensive analysis provides a definite benchmark for prognostication and epidemiology of NSCLC in a Western European society.
authors.affiliation: Medical University Innsbruck, Department of Internal Medicine V (Haematology and Oncology), Innsbruck, Austria; Tyrolean Cancer Research Institute, Innsbruck, Austria. Electronic address: florian.kocher@i-med.ac.at.
authors.forename: Florian
authors.initials: F
authors.lastname: Kocher
authors.affiliation: Medical University Innsbruck, Department of Internal Medicine V (Haematology and Oncology), Innsbruck, Austria; Wilhelminenspital Wien, Department of Internal Medicine I (Haematology and Oncology), Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hilbe
authors.affiliation: Medical University Innsbruck, Department of Internal Medicine V (Haematology and Oncology), Innsbruck, Austria; Tyrolean Cancer Research Institute, Innsbruck, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Seeber
authors.affiliation: Medical University Innsbruck, Department of Internal Medicine V (Haematology and Oncology), Innsbruck, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Pircher
authors.affiliation: Medical University Innsbruck, Deportment of Visceral, Transplant and Thoracic Surgery, Innsbruck, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmid
authors.affiliation: Paracelsus Medical University Salzburg, Department of Internal Medicine III (Haematology and Oncology), Salzburg, Austria.
authors.forename: Richard
authors.initials: R
authors.lastname: Greil
authors.affiliation: Paracelsus Medical University Salzburg, Department of Internal Medicine III (Haematology and Oncology), Salzburg, Austria.
authors.forename: Jutta
authors.initials: J
authors.lastname: Auberger
authors.affiliation: Medical University Innsbruck, Department of Radiotherapy and Radiation Oncology, Innsbruck, Austria.
authors.forename: Meinhard
authors.initials: M
authors.lastname: Nevinny-Stickel
authors.affiliation: Medical University Innsbruck, Department of Pathology, Innsbruck, Austria.
authors.forename: William
authors.initials: W
authors.lastname: Sterlacci
authors.affiliation: University Hospital Basel, Institute of Pathology, Basel, Switzerland.
authors.forename: Alexandar
authors.initials: A
authors.lastname: Tzankov
authors.affiliation: Academic Hospital Natters, Department of Pneumology, Natters, Austria.
authors.forename: Herbert
authors.initials: H
authors.lastname: Jamnig
authors.affiliation: Academic Hospital Natters, Department of Pneumology, Natters, Austria.
authors.forename: Karin
authors.initials: K
authors.lastname: Kohler
authors.affiliation: General Hospital Kufstein, Department of Internal Medicine, Kufstein, Austria.
authors.forename: August
authors.initials: A
authors.lastname: Zabernigg
authors.affiliation: General Hospital Vipiteno, Department of Internal Medicine, Vipiteno, Italy.
authors.forename: Josef
authors.initials: J
authors.lastname: Frötscher
authors.affiliation: Department of Clinical Epidemiology of TILAK/Cancer Registry of Tyrol, Innsbruck, Austria.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Oberaigner
authors.affiliation: Medical University Innsbruck, Department of Internal Medicine V (Haematology and Oncology), Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Fiegl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: Comorbidities; Comprehensive; Non-small cell lung cancer (NSCLC); Outcome; Registry; Symptoms