Table 1
Differences in treatment receipt and type of treatment by sex, age group, histology and stage, in ROR-SUL, 2009–2014.
| N (PATIENTS) | TREATMENT, N (%) | TYPE OF TREATMENT, N (%) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| TOTAL | YES | NO | p-VALUE | S (%) | p-VALUE | R (%) | p-VALUE | Sy (%) | p-VALUE | |
| Sex, N (%) | 11,308 (100) | 6,976 (61.7) | 4,332 (38.3) | <0.0001 | 2,326 (20.6) | <0.0001 | 2,855 (25.2) | 0.235 | 4,412 (39.0) | 0.880 |
| Male | 8,557 (75.7) | 5,200 (60.8) | 3.357 (39.2) | 1.635 (19.1) | 2,184 (25.5) | 3,342 (39.1) | ||||
| Female | 2,751 (24.3) | 1.776 (64.6) | 975 (35.4) | 691 (25.1) | 671 (24.4) | 1,070 (38.9) | ||||
| Age group, N (%) | 11,308 (100) | 6,976 (61.7) | 4,332 (38.3) | <0.0001 | 2,326 (20.6) | <0.0001 | 2,855 (25.2) | <0.0001 | 4,412 (39.0) | <0.0001 |
| <40 years | 130 (1.2) | 99 (76.2) | 31 (23.8) | 49 (37.7) | 41 (31.5) | 47 (36.2) | ||||
| 40–49 years | 768 (6.8) | 566 (73.7) | 202 (26.3) | 200 (26.0) | 294 (38.3) | 359 (46.7) | ||||
| 50–59 years | 2,240 (19.8) | 1,592 (71.1) | 648 (28.9) | 520 (23.2) | 744 (33.2) | 1,111 (49.6) | ||||
| 60–69 years | 3,521 (31.1) | 2,341 (66.5) | 1,180 (33.5) | 808 (22.9) | 937 (26.6) | 1,540 (43.7) | ||||
| 70–79 years | 3,315 (29.3) | 1,899 (57.3) | 1,416 (42.7) | 633 (19.1) | 668 (20.2) | 1,119 (33.8) | ||||
| >80 years | 1,334 (11.8) | 479 (35.9) | 855 (64.1) | 116 (8.7) | 171 (12.8) | 236 (17.7) | ||||
| Year of Diagnosis N (%) | 11,308 (100) | 6,976 (61.7) | 4,332 (38.3) | <0.0001 | 2,326 (20.6) | <0.0001 | 2,855 (25.2) | <0.0001 | 4,412 (39.0) | <0.0001 |
| 2009 | 1,801 (15.9) | 1,028 (57.1) | 773 (42.9) | 439 (24.4) | 417 (23.2) | 461 (25.6) | ||||
| 2010 | 1,815 (16.0) | 939 (51.7) | 876 (48.3) | 357 (19.7) | 373 (20.6) | 497 (27.4) | ||||
| 2011 | 1,815 (16.0) | 1,012 (55.8) | 803 (44.2) | 319 (17.6) | 426 (23.5) | 598 (32.9) | ||||
| 2012 | 2,023 (17.9) | 1,195 (59.1) | 828 (40.9) | 410 (20.3) | 469 (23.2) | 758 (37.5) | ||||
| 2013 | 1,937 (17.1) | 1.393 (71.9) | 544 (28.1) | 419 (21.6) | 594 (30.7) | 1,056 (54.5) | ||||
| 2014 | 1,917 (17.0) | 1,409 (73.5) | 508 (26.5) | 382 (19.9) | 576 (30.0) | 1,042 (54.4) | ||||
| Histology, N (%) | 11,308 (100) | 6,976 (61.7) | 4,332 (38.3) | <0.0001 | 2,326 (20.6) | <0.0001 | 2,855 (25.2) | <0.0001 | 4,412 (39.0) | <0.0001 |
| NSCLC | ||||||||||
| ADC | 5,095 (45.1) | 3,409 (66.9) | 1,686 (33.1) | 1,302 (25.6) | 1,353 (26.6) | 2,136 (41.9) | ||||
| SQCC | 2,423 (21.4) | 1,493 (61.6) | 930 (38.4) | 480 (19.8) | 623 (25.7) | 992 (40.9) | ||||
| Others1 | 740 (6.5) | 496 (67.0) | 244 (33.0) | 311 (42.0) | 129 (17.4) | 203 (27.4) | ||||
| NSCLC NOS | 847 (7.5) | 506 (59.7) | 341 (40.3) | 73 (8.6) | 262 (30.9) | 338 (39.9) | ||||
| SCLC | 1,164 (10.3) | 680 (58.4) | 484 (41.6) | 94 (8.1) | 309 (26.5) | 509 (43.7) | ||||
| OU | 1,039 (9.2) | 392 (37.7) | 647 (62.3) | 66 (6.4) | 179 (17.2) | 234 (22.5) | ||||
| Stage, N (%) | 8,531 (75.4) | 6,171 (72.3) | 2,360 (27.7) | <0.0001 | 2,326 (20.6) | <0.0001 | 2,855 (25.2) | <0.0001 | 4,412 (39.0) | <0.0001 |
| I | 1,187 (13.9) | 1,045 (88.0) | 142 (12.0) | 893 (75.2) | 125 (10.5) | 214 (18.0) | ||||
| II | 476 (5.6) | 378 (79.4) | 98 (20.6) | 271 (56.9) | 91 (19.1) | 241 (50.6) | ||||
| III | 1,877 (22.06) | 1,449 (77.2) | 428 (22.8) | 325 (17.3) | 797 (42.5) | 1,187 (63.2) | ||||
| IV | 4,491 (58.5) | 3,299 (66.1) | 1,692 (33.9) | 387(7.8) | 1,707 (34.2) | 2,450(49.1) | ||||
| Unknown | 2,777 (24.6) | 805 (29.0) | 1,972 (71.0) | 450 (16.2) | 135 (4.9) | 320 (11.5) | ||||
[i] ADC = Adenocarcinoma; SQCC = Squamous Cell Carcinoma; NSCLC NOS = Non-Small Cell Lung Cancer Not Otherwise Specified; SCLC = Small Cell Lung Cancer; OU = Other Unspecified;
1 Others: include large cell carcinoma, mixed carcinoma, neuroendocrine lung cancer, and others.
Table 2
Five-year overall survival related to treatment received, type of treatment and timely treatment, per sex and stage, ROR-SUL, 2009–2014.
| MEDIAN SURVIVAL IN DAYS (95%CI) | KAPLAN-MEIER OS (%) (95%CI) | ||||||
|---|---|---|---|---|---|---|---|
| Treatment received | |||||||
| All | Yes | No | p value | All | Yes | No | |
| All | 279 (269.1–188.9) | 430 (413.9–446.1) | 86 (79.6–92.4) | p < 0.0001 | 14.9 (14.3–15.5) | 19.6 (18.6–20.6) | 7.1 (6.3–7.9) |
| Stage | p < 0.0001 | ||||||
| I | n.r. | n.r. | 600 (313.5–886.5) | 60.4 (57.7–63.1) | 64.1 (61.2–67.0) | 32.9 (25.1–40.7) | |
| II | 1,086 (861.6–1310.4) | 1,377 (1074.6–1679.4) | 182 (64.6–299.4) | 37.4 (33.1–41.7) | 44.0 (38.9–49.1) | 12.0 (5.5–18.5) | |
| III | 424 (397.7–450.3) | 533 (498.7–567.3) | 115 (90.3–139.7) | 14.1 (12.5–15.7) | 16.9 (14.9–18.9) | 4.6 (2.6–6.6) | |
| IV | 171 (161.8–180.2) | 264 (252.5–275.5) | 51 (46.8–55.2) | 2.8 (2.4–3.2) | 3.5 (2.9–4.1) | 1.6 (1.0–2.2) | |
| Timely Treatment1 | |||||||
| All | Yes | No | p value | All | Yes | No | |
| All | 411 (395.8–426.1) | 280 (264.0–296.0) | 553 (426.0–580.0) | p < 0.0001 | 17.1 (16.1–18.1) | 11.3 (10.1–12.5) | 21.5 (20.1–22.9) |
| Stage | p < 0.0001 | ||||||
| I | n.r. | n.r. | n.r. | 63.3 (59.8–66.8) | 63.9 (56.8–71.0) | 63.2 (59.1–67.3) | |
| II | 1,363 (1046.4–1679.5) | 1,363 (–) | 1,370 (1017.6–1722.4) | 43.7 (38.4–49.0) | 45.1 (35.1–55.1) | 43.1 (36.8–49.4) | |
| III | 526 (491.9–560.1) | 426 (389.7–462.3) | 586 (545.8–626.2) | 16.5 (14.5–18.5) | 14.9 (11.8–18.0) | 17.3 (14.8–19.8) | |
| IV | 269 (257.6–280.4) | 204 (188.0–220.0) | 341 (319.5–362.5) | 3.5 (2.9–4.1) | 2.6 (1.8–3.4) | 4.5 (3.5–5.5) | |
| Timely Treatment per treatment type | |||||||
| All | Yes | No | p value | All | Yes | No | |
| Surgery2 | n.r. | 1,374 (–) | n.r. | p < 0.0001 | 51.7 (49.2–54.2) | 46.5 (42.8–50.2) | 55.9 (52.6–59.2) |
| Radiotherapy3 | 358 (339.2–376.8) | 229 (206.1–251.9) | 424 (398.3–449.6) | p < 0.0001 | 9.2 (8.0–10.4) | 5.9 (4.1–7.7) | 10.6 (9.2–12.0) |
| Systemic4 | 395 (338.8–409.2) | 284 (254.5–313.5) | 420 (403.9–436.1) | p < 0.0001 | 11.4 (10.4–12.4) | 7.9 (5.9–9.9) | 12.1 (10.9–13.3) |
| Timely Surgery2 | |||||||
| Stage | p < 0.0001 | ||||||
| I | n.r. | n.r. | n.r. | 74.5 (71.0–78.0) | 76.7 (70.8–82.6) | 73.3 (68.8–77.8) | |
| II | n.r. | n.r. | n.r. | 57.3 (50.8–63.8) | 62.2 (52.4–72.0) | 54.1 (45.9–62.3) | |
| III | 1,309 (1010.4–1607.6) | 1,374 (776.7–1971.3) | 1,240 (890.1–1589.9) | 41.0 (35.3–46.7) | 44.0 (34.8–53.2) | 39.1 (31.8–46.4) | |
| IV | 391 (322.8–459.2) | 347 (290.1–403.9) | 578 (514.3–641.7) | 10.9 (7.2–14.6) | 10.9 (6.6–15.2) | 11.3 (3.5–19.1) | |
[i] 1 Timely treatment according to RAND corporation guidelines (any type of treatment up to 6 weeks), 871 treated patients excluded from the analysis considering time from diagnosis to treatment was ≤0 (<0 – n = 156; 0 – n = 715); 2 Timely treatment according to BTS guidelines (surgery up to 8 weeks), 824 treated patients excluded from the analysis considering time from diagnosis to treatment was ≤0 (<0 – n = 135; 0 – n = 689), 3 Timely treatment according to BTS guidelines (radiotherapy up to 4 weeks), 101 treated patients excluded from the analysis considering time from diagnosis to treatment was ≤0 (<0 – n = 32; 0 – n = 69); 4 Timely treatment according to BTS guidelines (systemic therapy up to 3 weeks), 105 treated patients excluded from the analysis considering time from diagnosis to treatment was ≤0 (<0 – n = 31; 0 – n = 74); n.r. = not reached.
Supplement I
Distribution of treatment type per stage at diagnosis.
| I N (%) | II N (%) | III N (%) | IV N (%) | UNKNOWN N (%) | p-VALUE | |
|---|---|---|---|---|---|---|
| 1,188 (13.9) | 476 (5.6) | 1,877 (22.0) | 4,991 (58.5) | 2,777 (24.6) | ||
| Type of treatment, N (%) | ||||||
| Any treatment | 1,045 (88.0) | 387 (79.4) | 1,449 (77.2) | 3,299 (66.1) | 805 (29.0) | <0.0001 |
| No treatment | 143 (12.0) | 98 (20.6) | 428 (22.8) | 1,692 (33.9) | 1,972 (71.0) | <0.0001 |
| Surgery (S) only | 743 (62.5) | 97 (20.4) | 59 (3.1) | 144 (2.9) | 410 (14.8) | <0.0001 |
| Radiation (R) only | 76 (6.4) | 34 (7.1) | 176 (9.4) | 637 (12.8) | 70 (2.8) | <0.0001 |
| Systemic (Sy) only | 49 (4.1) | 49 (10.3) | 483 (25.7) | 1,390 (27.9) | 233 (8.4) | <0.0001 |
| S + R+ Sy | 10 (0.8) | 27 (5.7) | 129 (6.9) | 117 (2.3) | 8 (0.3) | <0.0001 |
| S + R | 12 (1.0) | 6 (1.3) | 27 (1.4) | 68 (1.4) | 5 (0.2) | 0.764 |
| S + Sy | 128 (10.8) | 141 (29.6) | 110 (5.9) | 58 (1.2) | 27 (1.0) | <0.0001 |
| R + Sy | 27 (2.3) | 24 (5.0) | 465 (24.8) | 885 (17.7) | 52 (1.9) | <0.0001 |
| S total | 893 (75.2) | 271 (56.9) | 325 (17.3) | 387 (7.8) | 450 (16.2) | <0.0001 |
| R total | 125 (10.5) | 91 (19.1) | 797 (42.5) | 1,707 (34.2) | 135 (4.9) | <0.0001 |
| Sy total | 214 (18.0) | 241 (50.6) | 1,187 (63.2) | 2,450 (49.1) | 320 (11.5) | <0.0001 |