Causes of death and conditional survival estimates of long-term lung cancer survivors.
Causes of death and conditional survival estimates of long-term lung cancer survivors.
复制标题
长期肺癌幸存者的死亡和有条件生存估计的原因。
DOI：
10.3389/fimmu.2022.1012247
复制
发表时间：
2022
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
--
作者：
肺癌是全球癌症相关死亡的主要原因。本回顾性队列研究旨在确定不同原因的时间依赖性死亡危险和肺癌的条件生存。我们在SEER数据库中收集了2000-2015年期间的816,436例肺癌病例，排除后，入组612,100例进行数据分析。本研究评估了癌症特异性生存、总生存和动态死亡风险。此外，基于2015年Nivolumab的FDA批准时间，我们通过比较2016-2018年（免疫治疗时代，n=7135）和2013-2016年（非免疫治疗时代，n=42061）的病例，评估免疫治疗对转移性患者生存的影响。在612,100例患者中，285,705例为女性，平均（SD）年龄为68.3（11.0）岁。肺腺癌252558例，肺鳞状细胞癌133302例，小细胞肺癌仅7.87万例。TNM分期为I期140,518例，II期38,225例，III期159,095例，IV期274,262例。手术干预164394例。5年总生存率和癌症特异性生存率分别为54.2%和73.8%。癌症特异性生存的5年条件生存率呈时间依赖性提高，而5年随访后的条件总生存率趋于稳定。根据条件生存曲线，除年龄外，其他危险因素（如分期和手术）的危险差异随着时间的推移而减小。诊断后8年，其他原因导致的死亡风险高于肺癌。这一关键时间点在老年患者中较早，而在晚期患者中推迟。此外，免疫治疗时代转移患者的肿瘤特异性生存期和总生存期均显著优于非免疫治疗时代（P<0.001），表明免疫治疗干预确实给晚期肺癌患者带来了显著的益处。我们的研究结果扩展了之前的研究，表明非肺癌相关的死亡风险在随访过程中变得越来越重要，我们建立了一个个性化的基于网络的计算器来确定长期幸存者的关键时间点。我们也证实了免疫治疗时代晚期肺癌患者的生存获益。
Lung cancer ranks the leading cause of cancer-related death worldwide. This retrospective cohort study was designed to determine time-dependent death hazards of diverse causes and conditional survival of lung cancer. We collected 816,436 lung cancer cases during 2000-2015 in the SEER database, after exclusion, 612,100 cases were enrolled for data analyses. Cancer-specific survival, overall survival and dynamic death hazard were assessed in this study. Additionally, based on the FDA approval time of Nivolumab in 2015, we evaluated the effect of immunotherapy on metastatic patients’ survival by comparing cases in 2016-2018 (immunotherapy era, n=7135) and those in 2013-2016 (non-immunotherapy era, n=42061). Of the 612,100 patients, 285,705 were women, the mean (SD) age was 68.3 (11.0) years old. 252,558 patients were characterized as lung adenocarcinoma, 133,302 cases were lung squamous cell carcinoma, and only 78,700 cases were small cell lung carcinomas. TNM stage was I in 140,518 cases, II in 38,225 cases, III in 159,095 cases, and IV in 274,262 patients. 164,394 cases underwent surgical intervention. The 5-y overall survival and cancer-specific survival were 54.2% and 73.8%, respectively. The 5-y conditional survival rate of cancer-specific survival is improved in a time-dependent pattern, while conditional overall survival tends to be steady after 5-y follow-up. Except from age, hazard disparities of other risk factors (such as stage and surgery) diminished over time according to the conditional survival curves. After 8 years since diagnosis, mortality hazard from other causes became higher than that from lung cancer. This critical time point was earlier in elder patients while was postponed in patients with advanced stages. Moreover, both cancer-specific survival and overall survival of metastatic patients in immunotherapy era were significantly better than those in non-immunotherapy era (P<0.001), indicating that immunotherapeutic intervention indeed bring remarkable benefits to advanced lung cancer patients. Our findings expand on previous studies by demonstrating that non-lung-cancer related death risk becomes more and more predominant over the course of follow-up, and we establish a personalized web-based calculator to determine this critical time point for long-term survivors. We also confirmed the survival benefit of advanced lung cancer patients in immunotherapy era.
登录
查看更多内容
影响因子：
7.3
作者：
Safi M;Al-Azab M;Jin C;Trapani D;Baldi S;Adlat S;Wang A;Ahmad B;Al-Madani H;Shan X;Liu J
通讯作者：
Liu J
影响因子：
4.6
作者：
Groth, Shawn S.;Rueth, Natasha M.;Maddaus, Michael A.
通讯作者：
Maddaus, Michael A.
DOI：
10.1158/1055-9965.epi-14-0130
发表时间：
2014-08
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Yu M;Feuer EJ;Cronin KA;Caporaso NE
通讯作者：
Caporaso NE
WNT5B 在肺腺癌进展中发挥致癌作用并受到 miR-5587-3p 的负向调节
影响因子：
8
作者：
Zhang, Qun;Fan, Hang;Song, Yong
通讯作者：
Song, Yong
影响因子：
3.4
作者：
Deng, Chaoqiang;Zhang, Yang;Chen, Haiquan
通讯作者：
Chen, Haiquan