Supervivencia global a largo plazo en el cáncer de pulmón. Análisis de una serie de 610 pacientes no seleccionados

[Survival of lung cancer patients treated at a referral hospital in Zaragoza (Spain)]

OBJECTIVE

The aim of this work is to study the survival of lung cancer patients treated at a referral hospital in Zaragoza (Spain).

MATERIAL AND METHOD

The Kaplan-Meier test was used to calculate observed survival. The automatic calculation of the Catalan Institute of Oncology was used to analyse relative survival.

RESULTS

Mean survival time was 25.74 months. There was no difference when comparing age groups (P=.151), gender (P=.369), and histological type of tumour (P=.086). Survival by stage of the disease at diagnosis revealed statistically significant differences (P<.001). Relative survival 5 years after diagnosis for the group analysed was 14%. Survival was higher for men (15.5%), in patients under 60 (16.7%) and squamous tumours (18.7%).

CONCLUSIONS

Survival by tumour stage was in line with the TNM Staging System for Lung Cancer. These results suggest that overall survival rate for lung cancer in Zaragoza remains very low in the long term, and this depends on the stage of the disease at diagnosis.

[Reason for a medical visit in the diagnosis of lung cancer. A review of 481 cases]

INTRODUCTION

Lung cancer is the most frequent cancer death related cause in the world. Its clinical presentation usually corresponds to advanced stages. The indication of screening programs for the diagnosis in early phases has been debated for years.

AIMS

To know the clinical characteristics in the presentation of the lung cancer in our health care area.

MATERIAL AND METHODS

All of the incident lung cancer cases for 3 years (January 1, 1997 to December 31, 1999) among those patients with usual residence in the Santiago de Compostela health care area were retrospectively collected from the available information in the Codification Service. The histological type was graded according to the World Health Organization classification. Date of death was obtained from the patient's clinical history, mortality record, or telephonic calls to the patient's home. The rest of the information was obtained from the clinical records of the patient and Pathology Service.

RESULTS

Four-hundred and eighty-one lung cancer cases were diagnosed (incident gross rate of 41.79 per 100,000 inhabitants and year). Median age was 66.9 years (interquartile range 60.5-74.4), 92.77% being males and 94.1% corresponding to smokers or former smokers. The most prevalent symptoms motivating the visit were general syndrome (20%), thoracic pain (19%) and hemoptisis (17%). A group of patients (56), fundamentally males, had an incidental diagnosis.

CONCLUSIONS

The incidence of lung cancer seems to be high in our health care area. The standard patient with lung cancer in this health care area is a 67-year-old, male, who smokes, diagnosed in advanced stages, who consults due to a general syndrome and/or chest pain. Some of the symptoms appear with significant gender differences. Likewise, there are differences between histologies, the high frequency of chest pain in adenocarcinoma being outstanding, although it is also the first cause for consultation in small cell lung cancer. On the contrary, hemoptisis, the most frequent consultation cause in squamous cell carcinoma and the general syndrome in the big cells type or with clinical-radiological diagnosis.