Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada.
Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada.
Curr Oncol. 2024 Jan 12;31(1):447-461. doi: 10.3390/curroncol31010030.
The prognosis of early non-small-cell lung cancer (eNSCLC) remains poor. An understanding of current therapies and outcomes can provide insights into how novel therapies can be integrated into clinics. We conducted a large, retrospective, population-based cohort study of patients with de novo eNSCLC (stages IB, IIA, IIB, and IIIA) diagnosed in Alberta, Canada, between 2010 and 2019. The primary objectives were to describe treatment patterns and survival outcomes among patients with eNSCLC. A total of 5126 patients with eNSCLC were included. A total of 45.3% of patients were referred to a medical oncologist, ranging from 23.7% in stage IB to 58.3% in IIIA. A total of 23.6% of patients initiated systemic therapy (ST), ranging from 3.5% in stage IB to 38.5% in IIIA. For stage IIB and IIIA individuals who received surgery, adjuvant ST was associated with a decreased likelihood of death (hazard ratios (HR) of 0.77 (95% CI: 0.56-1.07) and 0.69 (95% CI: 0.54-0.89), respectively). In a Canadian real-world setting, stage IIB and IIIA patients who received adjuvant ST tended to have better survival than patients who did not, but future studies that provide adjustment of additional confounders are warranted. Examining referral pathways that account for disparities based on age, sex, and comorbidities in the real world would also provide further insights.
早期非小细胞肺癌（eNSCLC）的预后仍然较差。了解当前的治疗方法和结果可以深入了解如何将新型疗法整合到临床实践中。我们对 2010 年至 2019 年期间在加拿大艾伯塔省诊断为初治 eNSCLC（IA 期、IB 期、IIA 期、IIB 期和 IIIA 期）的患者进行了一项大型回顾性基于人群的队列研究。主要目的是描述 eNSCLC 患者的治疗模式和生存结果。共纳入 5126 例 eNSCLC 患者。共有 45.3%的患者被转诊给肿瘤内科医生，IA 期的比例为 23.7%，IIIA 期的比例为 58.3%。共有 23.6%的患者开始接受系统治疗（ST），IA 期的比例为 3.5%，IIIA 期的比例为 38.5%。对于接受手术的 IIB 期和 IIIA 期患者，辅助 ST 与降低死亡风险相关（HR 分别为 0.77（95%CI：0.56-1.07）和 0.69（95%CI：0.54-0.89））。在加拿大真实环境中，接受辅助 ST 的 IIB 期和 IIIA 期患者的生存情况往往好于未接受 ST 的患者，但需要进一步的研究来调整其他混杂因素。检查基于年龄、性别和合并症的真实世界中的差异转诊途径也将提供进一步的见解。
