Author:
Orrason Andri W.,Sigurdsson Martin I.,Baldvinsson Kristjan,Thorsteinsson Hunbogi,Jonsson Steinn,Gudbjartsson Tomas
Abstract
We studied the rate of incidental detection of lung carcinomas and its effect on long-term survival in a nationwide cohort of patients operated for nonsmall cell lung cancer (NSCLC).All patients operated for NSCLC in Iceland during 1991–2010 were included. Demographic and clinicopathological features were compared in patients diagnosed incidentally using chest radiography or computed tomography (CT), and in those with symptomatic presentation. Multivariate analysis was used to evaluate prognostic factors.Out of 508 patients, 174 (34%) were diagnosed incidentally; in 26% of cases by chest radiography and in 8% by CT. The CT-detected tumours were significantly smaller than symptomatic tumours, diagnosed at earlier TNM (tumour, node and metastasis) stages and more often of adenocarcinoma histology. 5-year cancer-specific survival for symptomatic versus incidentally diagnosed patients detected by chest radiography and CT was 41%, 57% and 68%, respectively (p=0.003). After adjusting for stage, the hazard ratio (HR) for NSCLC mortality was significantly lower for incidental diagnosis by CT (HR 0.55, 95% CI 0.31‒0.98; p=0.04) compared to incidental diagnosis by chest radiography (HR 0.95, 95% CI 0.70‒1.27; p=0.71) or symptomatic diagnosis (HR 1.0).One-third of surgically treated NSCLCs were detected incidentally, with an increasing rate of incidental CT diagnosis. NSCLC patients diagnosed incidentally by CT appear to have better survival than those diagnosed incidentally by chest radiography, and particularly those who present with symptoms.
Publisher
European Respiratory Society (ERS)
Subject
Pulmonary and Respiratory Medicine
Reference26 articles.
1. Ferlay J , Soerjomataram I , Ervik M . GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon, International Agency for Research on Cancer. http://globocan.iarc.fr Date last accessed: August 20, 2014. Date last updated: 2013.
2. Lung cancer: clinical presentation and specialist referral time
3. Symptoms and reason for a medical visit in lung cancer patients;Gonzalez-Barcala;Acta Med Port,2014
4. Patient's and doctors’ delays in the diagnosis of chest tumors
5. Symptom lead time distribution in lung cancer: natural history and prospects for early diagnosis
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献