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匈牙利的早期可切除非小细胞肺癌

Early-stage resectable non-small cell lung cancer in Hungary.

作者信息

Gálffy Gabriella, Hécz Réka, Bujdosó Réka, Gáspár Eszter, Korompay Réka, Hoffer Judit, Szécsényi Szilvia, Blasszauer Celia, Reibl Dániel, Tóth Erika, Bogos Krisztina, Agócs László, Rényi-Vámos Ferenc, Mórocz Éva

机构信息

Department of Oncopulmonology, Pulmonology Center of the Reformed Church in Hungary, Törökbálint, Hungary.

AstraZeneca Ltd., Budapest, Hungary.

出版信息

Pathol Oncol Res. 2025 Jul 28;31:1612152. doi: 10.3389/pore.2025.1612152. eCollection 2025.

DOI:10.3389/pore.2025.1612152
PMID:40791752
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12336066/
Abstract

This study provides a comprehensive analysis of early-stage resectable non-small cell lung cancer (NSCLC) in Hungary, investigating incidence rates, demographic trends, treatment patterns and survival outcomes. We used data from the National Health Insurance Fund (NHIF) spanning 2013-2022, and we analyzed 6,571 patients with available NSCLC histology and no metastasis, who underwent curative surgery within 6 months of diagnosis, and evaluated epidemiological trends and the use of neoadjuvant and adjuvant therapies. For the efficacy analysis, we narrowed the patient cohort to 5,494 patients diagnosed and treated between 2013 and 2019 with at least three-year follow-up data. Key endpoints included overall survival (OS) and disease-free survival (DFS), inferred via time to first subsequent therapy (TFST). Our results revealed a gradual decline in early-stage resectable NSCLC diagnoses, with a significant drop in 2020, likely linked to COVID-19 restrictions. Older age groups (66-75 years) represented a growing proportion of cases, reflecting shifting demographic trends. Among patients with EGFR mutations receiving EGFR tyrosine kinase inhibitor (EGFR-TKI) therapy, OS significantly improved compared to those not receiving EGFR-TKI therapy, who are assumed to have wild-type EGFR status (HR = 0.58 (95% CI: 0.47-0.72), p < 0.0001). These findings underscore the importance of early detection, comprehensive biomarker testing and targeted therapies in improving outcomes for resectable NSCLC patients. Future studies with extended follow-up and integration of broader clinical data, including staging and patient comorbidities, are warranted to optimize therapeutic strategies.

摘要

本研究对匈牙利早期可切除非小细胞肺癌(NSCLC)进行了全面分析,调查了发病率、人口趋势、治疗模式和生存结果。我们使用了2013年至2022年国家健康保险基金(NHIF)的数据,分析了6571例有可用NSCLC组织学且无转移的患者,这些患者在诊断后6个月内接受了根治性手术,并评估了流行病学趋势以及新辅助和辅助治疗的使用情况。为了进行疗效分析,我们将患者队列缩小至2013年至2019年诊断并接受治疗且有至少三年随访数据的5494例患者。关键终点包括总生存期(OS)和无病生存期(DFS),通过首次后续治疗时间(TFST)推断得出。我们的结果显示,早期可切除NSCLC诊断呈逐渐下降趋势,2020年显著下降,这可能与COVID-19限制措施有关。老年年龄组(66 - 75岁)的病例比例不断增加,反映了人口趋势的变化。在接受表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗的EGFR突变患者中,与未接受EGFR-TKI治疗(假定为野生型EGFR状态)的患者相比,OS显著改善(HR = 0.58(95% CI:0.47 - 0.72),p < 0.0001)。这些发现强调了早期检测、全面的生物标志物检测和靶向治疗对于改善可切除NSCLC患者预后的重要性。有必要开展进一步随访并整合更广泛临床数据(包括分期和患者合并症)的未来研究,以优化治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/977c/12336066/1aaa2060c499/pore-31-1612152-g007.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/977c/12336066/9bc7f2424c01/pore-31-1612152-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/977c/12336066/1aaa2060c499/pore-31-1612152-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/977c/12336066/aebfd3a22740/pore-31-1612152-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/977c/12336066/180812074c7c/pore-31-1612152-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/977c/12336066/9bc7f2424c01/pore-31-1612152-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/977c/12336066/1aaa2060c499/pore-31-1612152-g007.jpg

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本文引用的文献

1
Decreasing incidence and mortality of lung cancer in Hungary between 2011 and 2021 revealed by robust estimates reconciling multiple data sources.2011 年至 2021 年期间匈牙利肺癌发病率和死亡率的下降,通过协调多个数据源的稳健估计得以揭示。
Pathol Oncol Res. 2024 Jun 3;30:1611754. doi: 10.3389/pore.2024.1611754. eCollection 2024.
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HUNCHEST projects-advancing low-dose CT lung cancer screening in Hungary.匈牙利肺癌低剂量 CT 筛查推进项目。
Pathol Oncol Res. 2024 May 9;30:1611635. doi: 10.3389/pore.2024.1611635. eCollection 2024.
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HUNCHEST-II contributes to a shift to earlier-stage lung cancer detection: final results of a nationwide screening program.
HUNCHEST-II 有助于更早发现肺癌:全国筛查计划的最终结果。
Eur Radiol. 2024 May;34(5):3462-3470. doi: 10.1007/s00330-023-10379-8. Epub 2023 Nov 3.
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Real-world study of disease-free survival & patient characteristics associated with disease-free survival in early-stage non-small cell lung cancer: A retrospective observational study.真实世界研究:早期非小细胞肺癌无疾病生存及与无疾病生存相关的患者特征:一项回顾性观察研究。
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Evaluation of data quality at the Hungarian National Cancer Registry, 2000-2019.2000 - 2019年匈牙利国家癌症登记处的数据质量评估
Cancer Epidemiol. 2023 Feb;82:102306. doi: 10.1016/j.canep.2022.102306. Epub 2022 Dec 13.
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[Comparison of Hungarian Central Statistical Office's causes of death data with the database of the Hungarian National Cancer Registry].[匈牙利中央统计局死亡原因数据与匈牙利国家癌症登记处数据库的比较]
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Diagnostic-Therapeutic Pathway and Outcomes of Early Stage NSCLC: a Focus on EGFR Testing in the Real-World.早期非小细胞肺癌的诊断-治疗路径及结局:聚焦真实世界中的表皮生长因子受体检测
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Characteristics and overall survival of patients with early-stage non-small cell lung cancer: A cohort study in Denmark.丹麦队列研究:早期非小细胞肺癌患者的特征和总生存率。
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Pathol Oncol Res. 2021 Dec 23;27:1610041. doi: 10.3389/pore.2021.1610041. eCollection 2021.