title: Time trends in surgery for lung cancer in France from 2005 to 2012: a nationwide study.
abstract: The aim of this study was to assess the evolution of survival in patients treated surgically for non-small cell lung cancer (NSCLC) between 2005 and 2012.From January 2005 to December 2012, 34 006 patients underwent pulmonary resection for NSCLC and were included in the French national database Epithor. Patients' characteristics, procedures and survival were analysed. Survival according to the management was evaluated for each 2-year period separately: 2005-2006, 2007-2008, 2009-2010 and 2011-2012.The proportions of early-stage cancers and adenocarcinomas increased significantly over the periods. 3-year overall survival (OS) increased significantly from 80.5% for the first period to 81.4% for the last period. For the periods 2005-2006 and 2007-2008, 3-year OS was lower after segmentectomy than after lobectomy (77 and 73% versus 82 and 83%, respectively). For the periods 2009-2010 and 2011-2012, 3-year OS in the two sub-groups was similar. OS after bi-lobectomy or pneumonectomy was lower than after lobectomy for all periods analysed. Systematic nodal dissection increased OS for all periods. Chemotherapy but not radiotherapy improved OS in the first 12 postoperative months for all periods.Changes in histological type and stage linked to advances in surgical and medical practices since 2005 led to an increase in OS in patients with surgical-stage NSCLC.
authors.affiliation: CHU Dijon, Bocage Central Hospital, Dijon, France.
authors.forename: Marie-Catherine
authors.initials: MC
authors.lastname: Morgant
authors.affiliation: CHU Dijon, Bocage Central Hospital, Dijon, France pierrebenoit.pages@chu-dijon.fr.
authors.forename: Pierre-Benoit
authors.initials: PB
authors.lastname: Pagès
authors.affiliation: CHU Marseille, North Hospital, Marseille, France.
authors.forename: Bastien
authors.initials: B
authors.lastname: Orsini
authors.affiliation: CHU Strasbourg, Civil Hospital, Strasbourg, France.
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Falcoz
authors.affiliation: CHU Marseille, North Hospital, Marseille, France.
authors.forename: Pascal-Alexandre
authors.initials: PA
authors.lastname: Thomas
authors.affiliation: CHU Toulouse, Larrey Hospital, Toulouse, France.
authors.forename: Françoise Le Pimpec
authors.initials: Fle P
authors.lastname: Barthes
authors.affiliation: CHU Toulouse, Larrey Hospital, Toulouse, France.
authors.forename: Marcel
authors.initials: M
authors.lastname: Dahan
authors.affiliation: CHU Dijon, Bocage Central Hospital, Dijon, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Bernard
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D005602:France; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000601:surgery; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D059035:Perioperative Period; D011013:Pneumonectomy; D011183:Postoperative Complications; D012372:ROC Curve; D012042:Registries; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends*; D016896:Treatment Outcome