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Evaluation of Lung Cancer Patients and Analysis of Factors Affecting Survival in Our Clinic: Zonguldak Bulent Ecevit University Hospital Example

Year 2022, Volume: 6 Issue: 1, 88 - 95, 28.04.2022
https://doi.org/10.29058/mjwbs.1067811

Abstract

Aim: Lung cancer emerges as an increasingly serious health problem in the world and in our country.
The aim of this study is to determine the clinical features, delays in diagnosis and treatment, survival,
and factors affecting survival of lung cancer patients followed in a tertiary hospital.
Material and Methods: In this retrospective study, the clinical, pathological, survival characteristics
and factors affecting survival of 210 lung cancer patients who applied to our clinic for diagnosis and
treatment were evaluated.
Results: The majority of the patients (mean age of 61.21±10.0) are males (90%), and 35% of the male patients were active/retired coal
miners. The vast majority of men (97.9%) and 14.3% of women were smokers or exsmokers. At the time of admission 82.8% of patients
were Eastern Cooperative Oncology Group (ECOG) performance status 0-1. The majority of patients (79.6%) were diagnosed with nonsmall
cell lung carcinoma. The rate of patients diagnosed with small cell lung carcinoma was 19.0%. The most common non-small cell lung
carcinoma subtype was squamous cell carcinoma (38.5%). 77.6% of the patients were diagnosed in locally advanced or metastatic stage.
The most common sites of metastasis are lung, bone, brain and liver, respectively. 9.6% of patients were not treated with curative methods.
The total time from symptom to treatment was found to be 121.01±81.68 days (median 99.00 days) in our study. The median survival was
8.9 months. In multivariate analysis, not receiving curative treatment, being at advanced stage, hypercalcemia, and hypoalbuminemia were
found statistically significant independent poor prognostic factors.
Conclusion: In this study, we found that not receiving curative treatment, having a high ECOG performance score, being in the
metastatic stage, being diagnosed with small cell carcinoma, longer the duration from time of emergence to treatment, hypercalcemia and
hypoalbuminemia adversely affected survival.

References

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209-249.
  • 2. Türkiye Kanser İstatistikleri 2017. TC Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, Ankara 2021. (https://hsgm.saglik. gov.tr/depo/birimler/kanser-db/istatistik/Turkiye_Kanser_ Istatistikleri_2017.pdf. Erişim tarihi 03.11.2021)
  • 3. Akciğer Kanseri Yol Haritası Birinci Basım: Şubat 2016. http://takd.org.tr/AkcigerYolHaritasiTRbasimVERSIYONU.pdf (Erişim tarihi: 05.10.2021)
  • 4. Babaoğlu AB, Tekindal M, Büyükuysal MÇ, Tözün M, Elmalı F, Bayraktaroğlu T, Tekindal MA. Epidemiyolojide gözlemsel çalışmaların raporlanması: STROBE kriterlerinin Türkçe uyarlaması. Batı Karadeniz Tıp Dergisi 2021;5(1):86-93.
  • 5. Yazici Guvercin AC, Tekindal MA, Kaymaz Ö, Guvercin CH. Methodological Comparison of Survival Analysis Methods in Censored Medical Data. Biomedical Research 2017;28(10):4360-4366.
  • 6. Tekindal MA, Kaymaz Ö, Ates C. Poisson Simulation Method: Software Development for Predicting the Number of Patients Based on Cancer Incidence Rate. İçinde: Arapgirlioglu H, Atik A, Hiziroglu S, Elliott R, Atik D, editörler. The Most Recent Studies in Science and Art. 1. Baskı. Gece Publishing; 2018. 1029-1041.
  • 7. Türk Toraks Derneği. Türkiye’de Temel Akciğer Sağlığı Sorunları ve Çözüm Önerileri. Türk Toraks Derneği Beyaz Kitap, 2010.
  • 8. Li L, Jiang M, Li X, Zhou B. Association between coalmine dust and mortality risk of lung cancer: A meta-analysis. Biomed Res Int 2021;2021:6624799.
  • 9. Graber JM, Stayner LT, Cohen RA, Conroy LM, Attfield MD. Respiratory disease mortality among US coal miners; Results after 37 years of follow-up. Occup Environ Med 2014;71(1):30- 39.
  • 10. Alberg AJ, Samet JM. Epidemiology of lung cancer. Chest 2003;123:21-49.
  • 11. Henry D Tazelaar. Pathology of lung malignancies. https:// www.uptodate.com/contents/pathology-of-lung-malignancies Erişim tarihi: 03.11.2021
  • 12. Cushman TR, Jones B, Akhavan D, Rusthoven CG, Verma V, Salgia R, Sedrak M, Massarelli E, Welsh JW, Amini A. The effects of time to treatment initiation for patients with nonsmall- cell lung cancer in the United States. Clin Lung Cancer 2021;22(1):84-97.
  • 13. Tsai CH, Kung PT, Kuo WY, Tsai WC. Effect of time interval from diagnosis to treatment for non-small cell lung cancer on survival: A national cohort study in Taiwan. BMJ Open 2020;10(4):0343512020.
  • 14. González-Barcala FJ, García-Prim JM, Álvarez-Dobaño JM, Moldes-Rodríguez M, García-Sanz MT, Pose-Reino A, Valdés- Cuadrado L. Effect of delays on survival in patients with lung cancer. Clin Transl Oncol 2010;12:836-842.
  • 15. Chandra S, Mohan A, Guleria R, Singh V, Yadav P. Delays during the diagnostic evaluation and treatment of lung cancer. Asian Pacific J Cancer Prev 2009;10:453-456.
  • 16. Annakkaya AN, Arbak P, Balbay O, Bilgin C, Erbas M, Bulut I. Effect of symptom-to-treatment interval on prognosis in lung cancer. Tumori 2007;93:61-67.
  • 17. Yilmaz A, Damadoglu E, Salturk C, Okur E, Tuncer LY, Halezeroglu S. Delays in the diagnosis and treatment of primary lung cancer: Are longer delays associated with advanced pathological stage? Upsala J Med Sci 2008;113(3):287-296.
  • 18. Gonzalez JM, De Castro FJ, Barrueco M, Cordovilla R, Fernandez JL, Gomez FP, De Vega BM, Ramos J, Serrano AR. Delays in the diagnosis of lung cancer. Arch Bronconeumol 2003;39:437-441.
  • 19. National Cancer Institute Surveillance, Epidemiology and End Results Program, Cancer Stat Facts: Lung and Bronchus Cancer. https://seer.cancer.gov/statfacts/html/lungb.html. Erişim Tarihi: 05.11.2021
  • 20. Goldstraw P, Chansky Bolejack V; International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions; International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee Advisory Boards and Participating Institutions. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol 2016;11(1):39-51.
  • 21. Hoang T, Xu R, Schiller JH, Bonomi P, Johnson DH. Clinical model to predict survival in chemonaive patients with advanced non-small-cell lung cancer treated with third-generation chemotherapy regimens based on eastern cooperative oncology group data. J Clin Oncol 2005;23(1):175.
  • 22. Kawaguchi T, Takada M, Kubo A, Matsumura A, Fukai S, Tamura A, Saito R, Maruyama Y, Kawahara M, Ignatius Ou SH. Performance status and smoking status are independent favorable prognostic factors for survival in non-small cell lung cancer: A comprehensive analysis of 26,957 patients with NSCLC. J Thorac Oncol 2010;5(5):620-630.
  • 23. Sculier JP, Chansky K, Crowley JJ, Van Meerbeeck J, Goldstraw P; International Staging Committee and Participating Institutions. The impact of additional prognostic factors on survival and their relationship with the anatomical extent of disease expressed by the 6th Edition of the TNM Classification of Malignant Tumors and the proposals for the 7th Edition. J Thorac Oncol 2008;3(5):457-466.
  • 24. Ando M, Ando Y, Sugiura S, Minami H, Saka H, Sakai S, Shimokata K, Hasegawa Y. Prognostic factors for short-term survival in patients with stage IV non-small cell lung cancer. Jpn J Cancer Res 1999;90(2):249-253.
  • 25. Ray P, Quantin X, Grenier J, Pujol JL. Predictive factors of tumor response and prognostic factors of survival during lung cancer chemotherapy. Cancer Detect Prev 1998;22:293-304.

Kliniğimizde İzlenen Akciğer Kanseri Hastalarında Klinik Özellikler ve Sağ Kalımı Etkileyen Faktörlerin Değerlendirilmesi: Zonguldak Bülent Ecevit Üniversitesi Hastanesi Örneği

Year 2022, Volume: 6 Issue: 1, 88 - 95, 28.04.2022
https://doi.org/10.29058/mjwbs.1067811

Abstract

Amaç: Akciğer kanseri dünyada ve ülkemizde giderek ciddi bir sağlık sorunu olarak karşımıza
çıkmaktadır. Bu çalışmanın amacı üçüncü seviye hastanede takip edilen akciğer kanseri hastalarının
klinik özelliklerini, tanı ve tedavideki gecikmelerini, sağ kalımı ve sağ kalımı etkileyen faktörleri
belirlemektir.
Gereç ve Yöntemler: Bu çalışmada kliniğimize tanı ve tedavi amacıyla başvuran 210 akciğer kanseri
hastasının klinik, patolojik, sağ kalım özellikleri ve sağ kalım üzerinde etkili olan faktörleri retrospektif
olarak değerlendirildi.
Bulgular: Yaş ortalaması 61,21±10,0 olan hastaların büyük çoğunluğu erkek olup (%90), erkeklerin
%35’i maden iş kolunda çalışmaktaydı. Erkeklerin büyük çoğunluğu (%97,9), kadınların ise %14,3’ü
sigara içmiş veya bırakmış hastalardı. Hastaların %82,8’inin başvuru sırasında Eastern Cooperative
Oncology Group performans durumlarının 0-1 olduğu saptandı. Hastaların çoğunluğu (%79,6) küçük
hücre dışı akciğer karsinomu tanısı almıştı. Küçük hücreli akciğer karsinomu tanısı alan hasta oranı ise
%19 idi. En sık görülen küçük hücre dışı akciğer karsinomu alt tipi skuamöz hücreli kanserdi (%38,5).
Hastaların %77,6’sı lokal ileri veya metastatik evrede tanı almıştı. En sık görülen metastaz bölgeleri
sırasıyla akciğer, kemik, beyin ve karaciğerdir. Küratif tedavi almayan hasta oranı %9.6 idi. Semptomdan
tedaviye geçen toplam süre çalışmamızda 121,01±81,68 gün (ortanca 99,00 gün) olarak saptandı.
Ortanca sağ kalım 8,9 ay olarak bulundu. Çalışmamızda çok değişkenli analiz sonucunda küratif tedavi
almamanın, ileri evrede olmanın, hiperkalsemi ve hipoalbuminemi olmasının istatistiksel anlamlı olarak
bağımsız kötü prognostik faktörler olduğu saptandı.
Sonuç: Bu çalışmada küratif tedavi almamanın, yüksek ECOG performans skoruna sahip olmanın,
metastatik evrede olmanın, küçük hücreli karsinom tanısı almanın, semptomdan tedaviye geçen sürenin
uzamasının, hiperkalsemi ve hipoalbumineminin sağ kalımı olumsuz yönde etkilediği bulunmuştur.

References

  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209-249.
  • 2. Türkiye Kanser İstatistikleri 2017. TC Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, Ankara 2021. (https://hsgm.saglik. gov.tr/depo/birimler/kanser-db/istatistik/Turkiye_Kanser_ Istatistikleri_2017.pdf. Erişim tarihi 03.11.2021)
  • 3. Akciğer Kanseri Yol Haritası Birinci Basım: Şubat 2016. http://takd.org.tr/AkcigerYolHaritasiTRbasimVERSIYONU.pdf (Erişim tarihi: 05.10.2021)
  • 4. Babaoğlu AB, Tekindal M, Büyükuysal MÇ, Tözün M, Elmalı F, Bayraktaroğlu T, Tekindal MA. Epidemiyolojide gözlemsel çalışmaların raporlanması: STROBE kriterlerinin Türkçe uyarlaması. Batı Karadeniz Tıp Dergisi 2021;5(1):86-93.
  • 5. Yazici Guvercin AC, Tekindal MA, Kaymaz Ö, Guvercin CH. Methodological Comparison of Survival Analysis Methods in Censored Medical Data. Biomedical Research 2017;28(10):4360-4366.
  • 6. Tekindal MA, Kaymaz Ö, Ates C. Poisson Simulation Method: Software Development for Predicting the Number of Patients Based on Cancer Incidence Rate. İçinde: Arapgirlioglu H, Atik A, Hiziroglu S, Elliott R, Atik D, editörler. The Most Recent Studies in Science and Art. 1. Baskı. Gece Publishing; 2018. 1029-1041.
  • 7. Türk Toraks Derneği. Türkiye’de Temel Akciğer Sağlığı Sorunları ve Çözüm Önerileri. Türk Toraks Derneği Beyaz Kitap, 2010.
  • 8. Li L, Jiang M, Li X, Zhou B. Association between coalmine dust and mortality risk of lung cancer: A meta-analysis. Biomed Res Int 2021;2021:6624799.
  • 9. Graber JM, Stayner LT, Cohen RA, Conroy LM, Attfield MD. Respiratory disease mortality among US coal miners; Results after 37 years of follow-up. Occup Environ Med 2014;71(1):30- 39.
  • 10. Alberg AJ, Samet JM. Epidemiology of lung cancer. Chest 2003;123:21-49.
  • 11. Henry D Tazelaar. Pathology of lung malignancies. https:// www.uptodate.com/contents/pathology-of-lung-malignancies Erişim tarihi: 03.11.2021
  • 12. Cushman TR, Jones B, Akhavan D, Rusthoven CG, Verma V, Salgia R, Sedrak M, Massarelli E, Welsh JW, Amini A. The effects of time to treatment initiation for patients with nonsmall- cell lung cancer in the United States. Clin Lung Cancer 2021;22(1):84-97.
  • 13. Tsai CH, Kung PT, Kuo WY, Tsai WC. Effect of time interval from diagnosis to treatment for non-small cell lung cancer on survival: A national cohort study in Taiwan. BMJ Open 2020;10(4):0343512020.
  • 14. González-Barcala FJ, García-Prim JM, Álvarez-Dobaño JM, Moldes-Rodríguez M, García-Sanz MT, Pose-Reino A, Valdés- Cuadrado L. Effect of delays on survival in patients with lung cancer. Clin Transl Oncol 2010;12:836-842.
  • 15. Chandra S, Mohan A, Guleria R, Singh V, Yadav P. Delays during the diagnostic evaluation and treatment of lung cancer. Asian Pacific J Cancer Prev 2009;10:453-456.
  • 16. Annakkaya AN, Arbak P, Balbay O, Bilgin C, Erbas M, Bulut I. Effect of symptom-to-treatment interval on prognosis in lung cancer. Tumori 2007;93:61-67.
  • 17. Yilmaz A, Damadoglu E, Salturk C, Okur E, Tuncer LY, Halezeroglu S. Delays in the diagnosis and treatment of primary lung cancer: Are longer delays associated with advanced pathological stage? Upsala J Med Sci 2008;113(3):287-296.
  • 18. Gonzalez JM, De Castro FJ, Barrueco M, Cordovilla R, Fernandez JL, Gomez FP, De Vega BM, Ramos J, Serrano AR. Delays in the diagnosis of lung cancer. Arch Bronconeumol 2003;39:437-441.
  • 19. National Cancer Institute Surveillance, Epidemiology and End Results Program, Cancer Stat Facts: Lung and Bronchus Cancer. https://seer.cancer.gov/statfacts/html/lungb.html. Erişim Tarihi: 05.11.2021
  • 20. Goldstraw P, Chansky Bolejack V; International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions; International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee Advisory Boards and Participating Institutions. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol 2016;11(1):39-51.
  • 21. Hoang T, Xu R, Schiller JH, Bonomi P, Johnson DH. Clinical model to predict survival in chemonaive patients with advanced non-small-cell lung cancer treated with third-generation chemotherapy regimens based on eastern cooperative oncology group data. J Clin Oncol 2005;23(1):175.
  • 22. Kawaguchi T, Takada M, Kubo A, Matsumura A, Fukai S, Tamura A, Saito R, Maruyama Y, Kawahara M, Ignatius Ou SH. Performance status and smoking status are independent favorable prognostic factors for survival in non-small cell lung cancer: A comprehensive analysis of 26,957 patients with NSCLC. J Thorac Oncol 2010;5(5):620-630.
  • 23. Sculier JP, Chansky K, Crowley JJ, Van Meerbeeck J, Goldstraw P; International Staging Committee and Participating Institutions. The impact of additional prognostic factors on survival and their relationship with the anatomical extent of disease expressed by the 6th Edition of the TNM Classification of Malignant Tumors and the proposals for the 7th Edition. J Thorac Oncol 2008;3(5):457-466.
  • 24. Ando M, Ando Y, Sugiura S, Minami H, Saka H, Sakai S, Shimokata K, Hasegawa Y. Prognostic factors for short-term survival in patients with stage IV non-small cell lung cancer. Jpn J Cancer Res 1999;90(2):249-253.
  • 25. Ray P, Quantin X, Grenier J, Pujol JL. Predictive factors of tumor response and prognostic factors of survival during lung cancer chemotherapy. Cancer Detect Prev 1998;22:293-304.
There are 25 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Article
Authors

Ayşegül Tomruk Erdem 0000-0002-5346-9107

Meltem Tor 0000-0003-2585-104X

Publication Date April 28, 2022
Acceptance Date March 19, 2022
Published in Issue Year 2022 Volume: 6 Issue: 1

Cite

Vancouver Tomruk Erdem A, Tor M. Kliniğimizde İzlenen Akciğer Kanseri Hastalarında Klinik Özellikler ve Sağ Kalımı Etkileyen Faktörlerin Değerlendirilmesi: Zonguldak Bülent Ecevit Üniversitesi Hastanesi Örneği. Med J West Black Sea. 2022;6(1):88-95.

Medical Journal of Western Black Sea is a scientific publication of Zonguldak Bulent Ecevit University Faculty of Medicine.

This is a refereed journal, which aims at achieving free knowledge to the national and international organizations and individuals related to medical sciences in publishedand electronic forms.

This journal is published three annually in April, August and December.
The publication language of the journal is Turkish and English.