Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011:3:139-48.
doi: 10.2147/CLEP.S17191. Epub 2011 Apr 28.

Survival by histologic subtype in stage IV nonsmall cell lung cancer based on data from the Surveillance, Epidemiology and End Results Program

Karynsa Cetin  1 , David S Ettinger, Yong-Jiang Hei, Cynthia D O'Malley
Affiliations

Survival by histologic subtype in stage IV nonsmall cell lung cancer based on data from the Surveillance, Epidemiology and End Results Program

Karynsa Cetin et al. Clin Epidemiol. 2011.

Abstract

Background: The role of histology in the targeted management of nonsmall cell lung cancer (NSCLC) has garnered renewed attention in recent years. We provide contemporary population-based estimates of survival and an assessment of important prognostic factors in stage IV NSCLC by major histologic subtype.

Methods: Using data from the Surveillance, Epidemiology and End Results (SEER) Program, we stratified 51,749 incident stage IV NSCLC patients (1988-2003 with follow-up through 2006) by major histologic subtype. We used Kaplan-Meier and Cox proportional hazards methods to describe overall survival and the prognostic influence of select patient, tumor, and treatment characteristics for each histologic subgroup.

Results: Survival was highest in patients with bronchioloalveolar adenocarcinoma (1-year survival: 29.1%) and lowest in those with large cell tumors (1-year survival: 12.8%). Diagnosis in later years, female gender, younger age, either Asian/Pacific Islander or Hispanic race/ethnicity, lower tumor grade, and surgery or beam radiation as part of first-line treatment were generally independently associated with a decreased risk of death, but the prognostic significance of some of these factors (age, ethnicity, tumor grade) varied according to histologic subtype.

Conclusion: Findings demonstrate a poor prognosis across histologic subtypes in stage IV NSCLC patients but highlight differences in both absolute survival and the relative importance of select prognostic factors by histologic subclassification. More research using other sources of population-based data could help clarify the role of histology in the presentation, management, and prognosis of late-stage NSCLC.

Keywords: epidemiology; histology; nonsmall cell lung cancer; survival.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan–Meier survival curves displaying 5-year survival and median survival time by histologic subtype for patients diagnosed with stage IV nonsmall cell lung cancer (NSCLC). Abbreviations:Adeno,adenocarcinoma;BAC,bronchioloalveolar adenocarcinoma; CI, confidence interval.
See this image and copyright information in PMC

References

    1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277–300. - PubMed
    1. Horner MJ, Ries LAG, Krapcho M, et al., editors. National Cancer Institute; 1975–2006. SEER cancer statistics review. http://seer.cancer.gov/csr/1975_2006. Accessed March 30, 2011.
    1. Caldarella A, Crocetti E, Comin CE, et al. Gender differences in non-small cell lung cancer: a population-based study. Eur J Surg Oncol. 2007;33(6):763–768. - PubMed
    1. Chen KY, Chang CH, Yu CJ, et al. Distribution according to histologic type and outcome by gender and age group in Taiwanese patients with lung carcinoma. Cancer. 2005;103(12):2566–2574. - PubMed
    1. de Perrot M, Licker M, Bouchardy C, et al. Sex differences in presentation, management, and prognosis of patients with non-small cell lung carcinoma. J Thorac Cardiovasc Surg. 2000;119(1):21–26. - PubMed