Long-term (>5 years) lung cancer survivors represent a small but distinct subgroup of lung cancer patients and information about the causes of death of this subgroup is scarce. Surveillance, epidemiology and end results (SEER) database (1988-2008) has been utilized to determine the causes of death of long-term survivors of lung cancer. Survival analysis has been conducted through Kaplan Meier analysis and multivariate analysis has been conducted through a Cox proportional hazard model. Clinicopathological characteristics and survival outcomes were assessed for the whole cohort. A total of 78,701 lung cancer patients with >5 years survival were identified. This cohort included 54488 patients surviving 5-10 years and 24213 patients surviving >10 years. Among patients surviving 5-10 years, 21.8% were dead because of primary lung cancer, 10.2% were dead because of other cancers, 6.8% were dead because of cardiac disease and 5.3% were dead because of non-malignant pulmonary disease. Among patients surviving >10 years, 12% were dead because of primary lung cancer, 6% were dead because of other cancers, 6.9% were dead because of cardiac disease and 5.6% were dead because of non-malignant pulmonary disease. On multivariate analysis, factors associated with longer cardiac disease-specific survival in multivariate analysis include younger age at diagnosis (P < 0.0001), white race (vs. African American race) (P = 0.005), female gender (P < 0.0001), right-sided disease (P = 0.003), adenocarcinoma (vs. large cell or small cell carcinoma) histology and receiving local treatment by surgery rather than radiotherapy (P < 0.0001). The probability of death from primary lung cancer is still significant among other causes of death even 20 years after diagnosis of lung cancer. Moreover, cardiac as well as non-malignant pulmonary causes contribute a considerable proportion of deaths in long-term lung cancer survivors.
PMID: 28426338 [Pubmed - Publisher]