24 Aug

Canadian Neighbor Pharmacy: Results of Clinical Features of 5,628 Primary Lung Cancer Patients

SmokersBetween 1997 and 2002, 6,077 primary lung cancer patients were identified; 5,759 patients received a new lung cancer diagnosis, and 318 patients had an initial lung cancer diagnosis before 1997. Among the 5,759 new patients, 5,717 patients (99%) gave permission to use their medical records for research. Eighty-nine patients (1.5%) were excluded because they were from outside of North America, leaving 5,628 patients for analysis.

Overall, women who received a lung cancer diagnosis were 2 years younger than men (p < 0.001) [Table 1]. Of the patients with known smoking status, 18% of the women and 7% of the men were never-smokers. Current smokers were the youngest patients at lung cancer diagnosis, and former smokers were the oldest (p < 0.001). Among smokers, women smoked nearly 11 pack-years less than men (mean pack-years, 46 vs 57, respectively; p < 0.001). Former smokers were more likely to have used other tobacco products (19.1%) than never-smokers (7.2%) and current smokers (8.5%; p < 0.001 between former and never-smokers or current smokers).

Tumor Histopathology and Disease Stage

Eighty-nine percent of all patients had non-small cell lung cancer (NSCLC), and 11% had small cell lung cancer (SCLC). Virtually all of the never-smokers had NSCLC, and the few who developed SCLC were all exposed to extensive second-hand smoke. Adenocarcinoma was the most frequent tumor subtype, irrespective of smoking status, however, showing a progressive decrease of prevalence in the different groups ranging from 63% in never-smokers, 47% in former smokers, and 39% in current smokers. This decrease corresponded with an associated increase in the prevalence of squamous cell and small cell carcinomas.

The majority of patients (65%) with NSCLC presented with late-stage disease. Never-smokers or former smokers were more likely to present with stage I disease than current smokers (p < 0.001).

Heart diseasesComorbid Conditions

The histories of selected medical (or comorbid) conditions by smoking status at the time of lung cancer diagnosis are shown in the bottom portion of Table 1. Former smokers had the highest prevalence of other cancers and heart diseases. All of the smokers had a higher prevalence of nonneoplastic lung diseases than the never-smokers, except for asthma. Lung cancer is a deteriorating disorder which do not force hand you are to begin treatment immediately. Canadian Neighbor Pharmacy may help you to purchase drugs necessary to be taken.

Treatment

Thirty-seven percent of the patients underwent surgery; 11% had received only chemotherapy, 8% only received radiotherapy, 13% received a combination of surgery and chemotherapy or radiotherapy, and 14% received both chemotherapy and radiotherapy. Two percent of the patients underwent other forms of treatment (photodynamic, laser, talc pleurodesis, hormone therapy, resection, or radiation to other tumor locations), and 15% received no treatment during our follow-up period. Although the majority of the surgical resections (86%) were performed at Mayo Clinic, more than one half of the patients (57%) received their initial chemotherapy or radiotherapy elsewhere.

Approximately 93% of all of the patients with stage I disease underwent surgical resection, and 10% of them had radiation and/or chemotherapy. Among stage II patients, 87% underwent surgical resection, and 27% of them had radiation and/or chemotherapy. Among stage III patients, 52% and 24%, respectively, were surgically resected for stage IIIA and IIIB disease; 66% received radiation and/or chemotherapy; and 15% were not treated.

Among stage IV patients, 27% did not receive any treatment; approximately 64% received radiation and/or chemotherapy (32% each), and 11% received surgical resection. For stage IV patients who received surgical treatment, 36% was for multiple lung nodules without distant metastasis, 30% was for other-organ metastasis (brain, adrenal, bone, eye, and other) without nodal involvement, and the rest (34%) were for miscellaneous metastases with nodal involvement.

COPDCause of Death

The cause of death information, confirmed by death certificates and medical records, was complete for the Olmsted County patients (n = 310). Based on 179 deceased patients in the study period, 92.7% died of lung cancer, with little variation across smoking status at their diagnosis. Other causes of death included other cancer, respiratory insufficiency or failure, COPD, pneumonia, internal hemorrhaging, and others.

Observed Survival Rates

The median survival time and the annual survival rate (with 95% confidence intervals [CIs]) after diagnosis were estimated with regard to disease stage and place of treatment (Table 2). The overall median survival time was 1.24 years (NSCLC patients, 1.32 years; SCLC patients, 1.00 year). Among NSCLC patients, except for those with stage IB and IIA disease, patients with an earlier stage of disease had a significantly better survival time than those with the disease stage immediately after (all with p < 0.001). Eliminating the 39 patients who died within 30 days of diagnosis and 155 patients with carcinoid tumors did not change the survival outcome significantly.

Stage-specific annual survival rates were significantly better for NSCLC patients who received their initial or entire treatment at Mayo Clinic compared with those who were treated elsewhere (p < 0.001). The opposite was observed for patients with extensive-stage SCLC (p < 0.001). Table 3 compares the 5-year survival rates (and 95% CI) among four subgroups of patients defined by whether or not they received a lung cancer diagnosis and were treated at Mayo Clinic. Note that the patients who were initially treated for extensive SCLC before coming to our institution were, on average, 11 years younger than other patients with the same stage of disease (p < 0.001).

NSCLCSurvival time by TNM staging for NSCLC is presented in Table 4, providing detailed subgroup-specific survival information within each stage. There was no difference in survival time among the stage IIB and IIIB TNM subgroups, whereas a significant difference was observed among the TNM subgroups within stage IIIA or IV disease (p < 0.01 for both). However, there was no significant difference between IIB and T3N1N0 (a subgroup of IIIA; p = 0.80). One hundred sixty-nine stage IIIB patients had T4N0M0 disease (satellite lesions, invasion of major vessels, trachea, carina, vertebral body, or malignant pleural effusions), with a median survival time of 1.63 years, which is significantly longer than other stage IIIB patients (0.85 year; p < 0.001). Forty-five stage IV patients had lung metastasis (T4N0M1) with a median survival time of 1.62 years, which is significantly longer than that for other stage IV patients (0.71 year; p = 0.008). Incomplete T and N data were found in < 1% of all of the NSCLC patients with M0 disease and in 64% with M1 disease.

Survival rate by other characteristics of patients is presented in Table 5, including tumor histology and grade, smoking status and intensity, and region of residence. Survival time varied significantly among the histologic subgroups, and was highest for typical carcinoids and salivary gland tumors and lowest for small cell and carcinoma with pleomorphic, sarcomatoid, or sarcomatous elements. Notably, 8% of all of the cases had nongraded tumors that included, mainly, advanced-stage NSCLC with no gradable tissue (mostly cytology only specimens) and rare histologic types that do not follow the existing grading system. Patients in the nongraded group had the shortest median survival time.

We compared our results with the published survival data based on the 5,319 patients who were treated between 1972 and 1988 as reported in a series by Moun-tain, by estimated 99% CIs from patients who were treated at Mayo Clinic between 1997 and 2003 (Fig 1). Lung cancer stage was primarily assigned pathologically and supplemented by clinical staging when necessary. The survival rates are considered similar when the point estimation from the reference is within the CI derived from our study. Taking the 5-year survival rate of stage IA as an example, 64% was reported from the series by Mountain, and 66% was observed in our cohort; however, the 99% CI for our point estimate was 59 to 73%, which includes 64%. Our data show a slightly but significantly better survival rate for patients with stage IIIB and IV NSCLC than that in the series by Mountain.

CancerDifferences Between Olmsted County (Local) and Referral Patients

Forty-four percent of all of the patients received a lung cancer diagnosis before their referrals to Mayo Clinic. More than one third of the patients (38%) were from Minnesota, 49% were from other Midwestern states (North Dakota, South Dakota, Nebraska, Kansas, Missouri, Iowa, Wisconsin, Illinois, Indiana, and Michigan), 12% were from other states across the United States, and the remaining 1% were from Canada and Mexico. Nearly 6% of the patients were local residents in Olmsted County, with a population of 116,000. As shown in Table 5, patients who received an initial lung cancer diagnosis at Mayo Clinic, regardless of whether they were from the local population or were referred from outside of Olmsted County, experienced very similar survival rates, with 5-year survival rates of 23% and 24%, respectively.

A significant difference was observed between the local and referral patients, and the later was overrepresented by never-smokers and early stage disease (p = 0.01 for both), although the gender ratio was similar. Tumor histology distribution by gender differed significantly: more adenocarcinomas and fewer squamous cell carcinomas were observed in women than in men (p < 0.001) for referral patients, but there was not a significant difference for the local patients. The histology distribution of referred women differed from that of local women (p = 0.01), but it was similar among men. The distribution of adenocarcinoma, squamous cell, and small cell carcinoma by smoking status at diagnosis between men and women for both the local and referral patients are depicted in Figure 2. There were fewer never-smokers and more former smokers in men than in women for adenocarcinoma and squamous cell carcinoma, and there were no never-smokers among local patients who developed SCLC (Fig 2, bottom left, C, and bottom right, D). The female adenocarcinoma patients were evenly distributed across smoking status, whereas very few female squamous cell and small cell carcinoma patients were never-smokers (Fig 2, top right, B and bottom right, D).

SCLCFor NSCLC, similar distributions of smoking status across the stages were observed between the local and referral patients, except for stage IV, where more never-smokers and fewer current smokers were seen among the referral patients than among the local patients (p = 0.04). For SCLC, similar patterns were seen between men and women among the referral patients, but dissimilar patterns were seen among local patients with extensive stage, which could be attributable to the small number of patients in this group (data not shown).

Resources Available for Clinical and Basic Science Studies

We have also obtained comprehensive data from patients beyond the ordinary demographic and clinical information at the time of diagnosis. These data were collected through patient interviews and periodic follow-up. For example, ethnicity background was obtained based on self-reported country-of-origin of a patient’s four grandparents.

Table 6 presents the patients with special characteristics. For example, 16% of the patients had at least one first-degree relative with lung cancer, 16% had at least two first-degree relatives with other cancers, 10% were never-smokers, 11% received a lung cancer diagnosis at < 50 years of age (2% received a lung cancer diagnosis while 80 years of age, and 11% had an uncommon tumor type or subtype (eg, bronchi-oloalveolar carcinoma, pleomorphic/sarcomatoid, muco-epidermoid, salivary-gland type, and carcinoids). Numerous research projects have been initiated utilizing these special patient groups, and the patient participation rate and biological sample availability are also provided in Table 6.

Information regarding second-hand smoke and other environmental exposures was also collected for research purposes. For example, among the 246 male and 120 female never-smokers with other exposure information, 74% of the men and 78% of the women were exposed to second-hand smoke. More than 70% of men who did not report a second-hand smoking history had extensive exposure to petroleum and farm chemicals, in contrast with < 30% of men who were passive smokers and who had such exposures (p = 0.002).

Fig1

Figure 1. Five-year survival rates and 99% CIs of Mayo Clinic NSCLC patients compared with a reference. □, average survival rates for each disease stage based on the series by Mountain estimated by proportions of the patients with clinical or pathologic staging. О with lines, estimated survival rates and 99% CIs for the Mayo Clinic series in the current study.

Fig2

Figure 2. Adenocarcinoma, squamous cell, and small cell carcinoma distribution by cigarette smoking status of primary lung cancer patients diagnosed between 1997 and 2002 at the Mayo Clinic. Top left, A: male referral patients (n = 2,090). Top right, B: female referral patients (n = 1,536). Bottom left, C: Olmsted County male patients (n = 140). Bottom right, D: Olmsted County female patients (n = 116).

Table 1—Demographic and Clinical Information by Cigarette Smoking Status of 5,628 Patients in Whom Primary Lung Cancer Was Diagnosed Between 1997 and 2002 at Mayo Clinic

Characteristics All Patients

(n = 5,628)

Smoking Status at Lung Cancer Diagnosis
Never-Smokers (n = 644) [11.4%] Former Smokers (n = 2,231) [39.6%] Current Smokers (n = 1,948) [34.6%
Male/female ratio 1.4 0.5 1.9 1.2
Age at diagnosis, yr 65.4 ± 11.0 63.9 ± 14.3 68.8 ± 9.6 61.7 ± 10.7
Women (n = 2,370) 64.2 ± 11.4 64.4 ± 14.1 67.5 ± 9.6 60.9 ± 11.0
Men (n = 3,258) 66.3 ± 10.7 63.1 ± 14.9 69.5 ± 9.5 62.4 ± 10.5
Other tobacco use (n = 4,314)
None 3,738 (86.7) 494 (92.7) 1,600 (80.9) 1,487 (91.5)
Cigars and/or pipes 477 (11.1) 34 (6.4) 309 (15.6) 120 (7.3)
Chewing tobacco only 99 (2.3) 5 (0.9) 69 (3.5) 19(1.2)
Histology (n = 5,616)
Adenocarcinoma 2,546 (45.3) 406 (63.1) 1,051 (47.1) 751 (38.7)
Squamous cell carcinoma 1,334 (23.7) 53 (8.2) 572 (25.7) 498 (25.7)
Large cell carcinoma! 159 (2.8) 8(1.2) 55 (2.5) 70 (3.6)
Unclassified NSCLC 679(12.1) 62 (9.6) 245 (11.0) 243 (12.5)
Small cell carcinoma 635 (11.3) 16(2.5) 210 (9.4) 325 (16.7)
Carcinoid tumorsj 155 (2.8) 78 (12.1) 52 (2.3) 18 (0.9)
Mixed histologic types§ 61 (1.1) 12 (1.9) 23(1.0) 17 (0.9)
Other histologic types | 47 (0.8) 8 (1.2) 21 (0.9) 18 (0.9)
Disease stage at diagnosis (n = 5,626)
NSCLC 4,991 (88.7) 628 (97.5) 2,021 (90.6) 1,621 (83.3)
Stage I 1,291 (26.4) 182 (29.5) 614 (30.9) 407 (25.6)
Stage II 413 (8.4) 30 (4.9) 188 (9.5) 143 (9.0)
Stage III 1,482 (30.3) 180 (29.2) 545 (27.4) 477 (30.0)
Stage IV 1,706 (34.9) 225 (36.5) 640 (32.2) 565 (35.5)
SCLC 635 (11.3) 16(2.5) 210 (9.4) 325 (16.7)
Limited 294 (47.0) 6 (37.5) 95 (45.9) 158 (49.2)
Extensive 331 (53.0) 10 (62.5) 112 (54.1) 163 (50.8)
Comorbid conditions^ (n = 3,483)
Other cancer 941 (27.0) 135 (27.3) 520 (32.1) 258 (20.2)
Cancer of both genders# 680 (19.5) 85 (17.2) 389 (24.0) 187 (14.6)
Female cancer 172 (11.2) 41 (12.7) 68(11.9) 60 (9.9)
Male cancer 197 (10.1) 23(13.5) 130 (12.4) 36 (5.4)
Nonneoplastic lung disease 1,501 (43.1) 140 (28.3) 741 (45.8) 588 (46.0)
COPD 1,144 (32.9) 53 (10.7) 577 (35.6) 489 (38.3)
Asthma 284 (8.1) 49 (9.9) 143 (8.8) 91 (7.1)
Other lung disease** 629(18.1) 81 (16.4) 314 (19.4) 226 (17.7)
Diabetes 188 (5.4) 17 (3.4) 111 (6.7) 56 (4.4)
Heart disease 385 (11.1) 43 (8.7) 221 (13.7) 105 (8.2)
Hypertension 454 (13.0) 71 (14.3) 240 (14.8) 134 (10.5)
Cerebral vascular accident 105 (3.0) 18 (3.6) 47 (2.9) 38 (3.0)
Other diseaseft 595 (17.1) 73 (14.7) 309(19.1) 202 (15.8)

Table 2—Lung Cancer Survival by Stage and by Place of Treatment Among Patients in Whom Lung Cancer Was Diagnosed Between 1997 and 2002 at Mayo Clinic

Stage at Diagnosis No. MST, yr Lung Cancer Survival After Date of Diagnosis
1-yr 2-yr 3-yr 4-yr 5-yr
All patients 5,628 1.24 57 (56-58) 37 (36-39) 27 (26-29) 22 (21-23) 18 (17-19)
NSCLCt 4,991 1.32 58 (57-59) 39(38-41) 29 (28-31) 23 (22-25) 19(18-21)
IA 746 6.19 93(91-95) 83(80-86) 73 (69-76) 67 (63-71) 59 (54-64)
IB 545 4.12 86(83-89) 73 (69-77) 58 (53-63) 51 (46-57) 44 (39-50)
IIA 99 3.12 82 (75-90) 63 (53-74) 51 (42-63) 43 (33-55) 40 (30-53)
IIB 314 2.14 72 (67-77) 53 (47-59) 39 (34-46) 33 (27-39) 29 (23-37)
IIIA 714 1.37 62 (59-66) 38 (34-42) 26 (22-29) 15(13-19) 8(5-12)
IIIB 768 0.88 44 (41-48) 23 (20-26) 14(11-17) 8(6-11) 6(4-10)
IV 1706 0.63 34(31-36) 14(13-16) 7(6-9) 4(3-5) 2(1-3)
Treated at Mayo Clinicj 2559 2.17 67 (65-69) 52 (50-54) 42 (40-44) 36 (34-38) 31 (29-34)
IA 611 —§ 93(91-95) 85 (82-88) 77(73-81) 72 (67-76) 66(60-71)
IB 419 5.48 89 (85-92) 77 (73-82) 64 (59-69) 59 (54-65) 53 (47-60)
IIA 70 3.27 84 (76-93) 66 (55-79) 53 (42-68) 46 (34-61) 42 (30-59)
IIB 198 2.54 74(68-81) 57 (50-64) 46 (39-54) 39 (32-48) 36 (29-45)
IIIA 385 1.43 64 (60-70) 41 (36-47) 30 (25-35) 19 (15-25) 10(7-16)
IIIB 301 0.90 45(39-51) 26 (21-31) 16(12-22) 13 (9-20) 12 (7-19)
IV 571 0.63 34 (30-38) 16(13-20) 10(8-13) 5(3-8) 4 (2-7)
SCLC|| 635 1.00 50 (46-54) 21(18-25) 13 (10-16) 10(8-14) 9(6-12)
Limited 294 1.31 67 (62-73) 36(31-43) 24 (19-30) 20 (16-27) 17 (12-23)
Extensive 332 0.71 16(31-42) 8(6-12) 3(1-6) 2(1-5) 2(1-5)
Treated at Mayo Clinicj 272 0.94 46(41-53) 19 (15-24) 11 (8-17) 11 (8-17) 11 (7-16)
Limited 120 1.22 64 (55-73) 35 (27-44) 24 (17-34) 24 (17-34) 22 (15-32)
Extensive 151 0.68 33 (26-41) 6(3-12) 1 (0-7) 1 (0-7) 1 (0-7)

Table 3—5-Year Survival Rates by Place of Diagnosis and Treatment Among Patients in Whom Lung Cancer Was Diagnosed Between 1997 and 2002 at Mayo Clinic

Stage at Diagnosis Diagnosed and Treated at Mayo Diagnosed at Mayo, Treated Elsewhere Diagnosed Elsewhere, Treated at Mayo Diagnosed and Treated Elsewhere
No.t Survival No. Survival No. Survival No. Survival
All patients 2,191 32 (30-35) 291 4 (2-9) 640 18(14-23) 759 11(8-15)
NSCLC 1,968 35 (32-38) 241 3 (1-8) 591 18(14-24) 694 10 (7-14)
IA 561 66(61-72) 6 0(-) 50 52 (30-90) 73 19 (8-42)
IB 323 56 (49-63) 5 0(-) 96 42 (28-61) 51 18 (8-42)
IIA 61 44 (32-62) 0 9 0(-) 15 0(-)
IIB 143 34 (26-45) 7 0(-) 55 43 (31-60) 54 17 (6-47)
IIIA 282 11 (7-19) 51 8 (2-26) 103 5 (1-27) 120 9 (3-24)
IIIB 194 13 (7-22) 52 3(121) 107 10 (5-22) 113 8(3-21)
IV 402 4 (2-8) 117 0(-) 169 3(1-11) 246 3(1-8)
SCLC 223 11 (7-17) 50 15 (7-33) 49 10 (4-24) 65 17 (9-34)
Limited 105 22(15-33) 26 29 (14-60) 15 22 (8-60) 39 20 (9-44)
Extensive 117 0(-) 23 0(-) 34 4(1-24) 25 17 (6-50)

Table 4—NSCLC Survival by TNM Stage Among Patients in Whom Lung Cancer Was Diagnosed Between 1997 and 2002 at Mayo Clinic

Stage at Diagnosis Tumor Stage No. MST, yr Lung Cancer Survival After Date of Diagnosis
1-yr 2-yr 3-yr 4-yr 5-yr
IA T1N0M0t 747 6.19 93(91-95) 83 (80-86) 73 (69-76) 67(63-71) 59 (54-64)
IB T2N0M0J 545 4.12 86(83-89) 72 (69-77) 58 (53-63) 51 (46-57) 44 (39-50)
IIA T1N1M0§ 99 3.12 82 (75-90) 63 (53-74) 51 (42-63) 43 (33-55) 40 (30-53)
IIB ALL IIB|| 314 2.14 72 (67-77) 53 (47-59) 39 (34-46) 33 (27-39) 29 (23-37)
T2N1M0 179 2.33 77 (70-83) 56 (49-64) 43(35-51) 33 (26-43) 30 (22-40)
T3N0M0 134 1.86 66 (58-75) 49 (41-59) 35 (27-46) 32 (24-43) 30 (21-41)
IIIA ALL IIIAf 715 1.37 63 (59-66) 38 (34-42) 26 (22-30) 16(13-19) 8(6-12)
T3N1M0 43 2.18 69 (56-85) 53 (39-71) 42 (28-62) 33(19-55) 26 (13-52)
T1N2M0 128 1.62 74 (66-82) 48 (39-58) 32 (24-43) 23 (16-34) 20 (12-33)
T2N2M0 347 1.26 58 (53-64) 35 (30-41) 25 (20-30) 14 (10-19) 6(3-11)
T3N2M0 129 1.07 57 (49-66) 31 (23-41) 19(13-28) 12 (7-22)
TXN2M0 43 1.43 68 (55-84) 35 (23-55) 24(13-43) 7(1-38)
TXNXM0 18 1.51 76 (58-100) 49 (29-82) 14 (4-50)
IIIB ALL IIIB# 766 0.88 44(41-48) 23 (20-26) 14(11-17) 8(6-11) 6 (4-9)
T4N0M0 169 1.63 63 (55-71) 43 (35-51) 30 (23-39) 17(11-27) 14 (8-24)
T4N1M0 38 1.11 51 (37-70) 32 (20-53) 18(8-41) 18(8-41) 18(8-41)
T4N2M0 172 0.90 45 (38-53) 17 (12-24) 7(3-13)
T1N3M0 34 1.02 51(36-71) 25 (14-46) 14 (5-35) 9(3-31)
T2-3N3M0 74 0.80 40 (30-54) 15 (9-27) 9(4-21) 6 (2-19) 6 (2-19)
T4N3M0 29 0.59 22(11-44) 4(1-28)
T4NXM0 165 0.57 29 (23-37) 14(9-21) 9 (5-15) 6(3-12) 3(1-10)
TXN3M0 50 0.86 37 (26-54) 20(11-36) 13 (5-31) 13 (5-31)
TXNXM0 26 1.03 52 (35-78) 25 (10-60) 12 (2-64) 12 (2-64) 12 (2-64)
M0** Miss T or N 36 2.21 75 (62-91) 58 (42-79) 31 (17-57) 31 (17-57) 31 (17-57)
IV ALL IV 1706 0.63 33(31-36) 14(12-16) 7 (6-9) 4 (3-5) 2 (1-3)
T1N0M1 33 1.91 70 (56-87) 44 (29-65) 36 (23-58) 13 (5-35)
T2-3N0M1 66 1.14 61 (50-74) 32 (22-47) 23 (14-38) 17 (9-33) 14 (6-30)
T4N0M1 45 1.62 53 (40-70) 43 (31-61) 16(8-35) 16 (8-35) 8 (2-39)
T1-3N1M1 33 0.61 46(31-66) 27 (15-49) 16(6-41) 16(6-41) 16(6-41)
T4N1M1 19 1.25 56 (37-84) 25 (10-63) 25(10-63) 8(1-52)
T1-3N2M1 200 0.65 29 (23-36) 13(9-19) 5 (2-10) 2 (1-7) 1 (0-6)
T4N2M1 127 0.54 37 (30-47) 13 (8-21) 10(6-18) 7(3-13) 3 (1-9)
T1-4N3M1 88 0.64 35 (27-47) 14(8-23) 5 (2-13) 2(0-10) 2(0-10)
TXNXM1it 1095 0.57 30 (27-32) 10(9-13) 4 (3-6) 2 (1-3) 1 (0-2)
Unknown M 58 1.31 60 (48-74) 42 (31-58) 31 (20-47) 23(14-39) 16 (7-34)

Table 5—Lung Cancer Survival by Other Factors Among Patients Diagnosed Between 1997 and 2002 at Mayo Clinic

Characteristics No. MST,

yr

Lung Cancer Survival After Date of Diagnosis
1-yr 2-yr 3-yr 4-yr 5-yr
Tumor histology
Adenocarcinoma/bacterial artificial 2,546 1.49 61 (59-63) 43(41-45) 31 (29-33) 24 (22-26) 20 (28-22)
chromosome
Squamous cell 1,334 1.37 59 (56-62) 41 (38-44) 31 (28-34) 25 (22-28) 19 (17-23)
Large cell 159 1.14 54 (46-62) 33 (26-41) 28 (21-37) 26(19-35) 21(14-30)
Adenosquamousf 51 1.33 64 (52-79) 43(31-59) 31(19-51) 26 (14-48) 14 (5-41)
Other NSCLC 689 0.73 37 (34-41) 15(13-19) 7 (5-10) 4 (2-7) 3 (1-5)
Pleomorphic/sarcomatoid 39 0.71 36 (24-56) 22(12-41) 10 (3-32) 10(3-32)
Small cell 635 1.00 50 (46-54) 21 (18-25) 13 (10-16) 10(8-14) 9(6-12)
Typical carcinoid 127 t

t

94 (90-99) 93 (89-98) 90 (85-96) 87 (80-95) 82 (72-92)
Atypical carcinoid 28 5.75 92(83-100) 79 (65-97) 63 (45-88) 56 (37-84) 56(37-84)
Salivary gland type 8 t

t

100 (-) 100 (-) 100 (-) 100 (-) 100 (-)
Tumor grade
Well-differentiated 708 4.47 84 (81-86) 71 (68-75) 60 (56-64) 54 (49-59) 48 (43-54)
Moderately differentiated 1,879 1.60 64 (61-66) 43 (41-46) 32 (30-35) 25 (23-28) 20(18-23)
Poorly/undifferentiated 2,370 0.92 47 (45-49) 25 (23-27) 16(15-18) 12(11-14) 10(8-11)
Nongradeable 445 0.81 41 (37-46) 21(18-26) 12 (9-16) 6(4-10) 5 (3-9)
Cigarette smoking status
Never-smoker 644 1.70 67 (63-71) 45(41-49) 35(31-40) 30 (26-35) 24 (20-30)
Former smoker 2,231 1.43 60 (58-62) 42 (40-44) 32 (30-34) 26 (24-28) 22 (20-25)
Current smoker 1,948 1.16 56 (54-58) 35 (33-38) 26 (23-28) 21(19-23) 18(16-20)
Some smoking history§ 730 0.88 45 (42-49) 24 (21-27) 14 (12-17) 7 (5-10) 4 (2-6)
Pack-years
1-30 1,070 1.40 60 (57-63) 42 (39-46) 34(31-38) 29 (26-32) 25 (22-29)
31-60 1,733 1.25 57 (55-60) 37 (35-40) 27 (25-29) 21(19-24) 17 (15-20)
> 60 1,219 1.20 57 (55-60) 37 (34-40) 27 (24-29) 22 (20-25) 19 (17-22)
Olmsted County residents
No 5,318 1.25 57 (56-59) 37 (36-39) 27 (26-29) 22 (20-23) 18(16-19)
1st diagnosis at Mayo 2,864 1.23 56 (54-57) 40(38-41) 31 (29-33) 26 (24-28) 23 (21-25)
1st diagnosis elsewhere 2,454 1.26 59 (57-61) 35 (33-37) 23 (21-25) 16 (14-18) 11 (9-13)
Yes 310 1.13 55 (49-60) 37 (32-43) 29 (24-35) 26 (21-32) 24(18-30)

Table 6—Selected Characteristics of Primary Lung Cancer Patients in a Comprehensive Resource for Research at the Mayo Clinic

Characteristics of Probandsf Patients Age at Diagnosis, yr Men/

Women

Ratio

Percent

Never-

Smokers

Enrolled for Research! Biological

Samples

Received§

With one or more first-degree relative with lung cancer 878 (15.6) 65.6 ± 10.6 1.3 9.1 545 (62.1) 406 (74.5)
With two or more first-degree relatives with other cancers 922 (16.4) 68.4 ± 10.2 1.1 14.5 516 (56.0) 381 (73.8)
With three or more first-degree relatives with any cancers 532 (9.5) 69.0 ± 9.6 1.1 11.9 306 (57.5) 230 (75.2)
Lifetime nonsmokers| 547 (9.7) 63.1 ± 14.3 0.5 100 361 (66.0) 271 (75.1)
Age s 50 yr at dx 572 (10.2) 44.1 ± 5.3 0.9 23.6 335 (58.6) 226 (67.5)
Age a 80 yr at dx 444 (7.9) 83.0 ± 2.8 1.8 20.6 194 (43.7) 138(71.1)
With an uncommon tumor 607 (10.8) 64.0 ± 12.8 0.9 27.0 423 (69.7) 349 (82.5)
Olmsted County residents 306 (5.4) 69.0 ± 10.9 1.2 7.5 172 (56.2) 127 (73.8)
Sporadic lung cancer^ 1,205 (21.4) 65.8 ± 7.4 1.6 0.0 597 (49.5) 457 (76.5)
Total# 5,628 65.4 ± 11.0 1.4 11.6 2,762 (49.1) 2,056 (74.4)

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