Background
Methods
Results
Study follow-up and baseline characteristics of the study population
Mortality rates within the 1st year following diagnosis
Characteristics of the patients according to their vital status at 1 and 3 months
Vital status at | |||||||
---|---|---|---|---|---|---|---|
1 month | 3 months | ||||||
Alive | Dead | Alive | Dead | ||||
N
|
N = 6,303 |
N = 678 |
p-value
|
N = 5,360 |
N = 1,621 |
p-value
| |
Sex |
n
= 6,303
|
n
= 678
|
0.018
|
n
= 5,360
|
n
= 1,621
|
0.097
| |
Men, n (%) | 5,286 | 4,747 (75.3) | 539 (79.5) | 4,033 (75.2) | 1,253 (77.3) | ||
Women, n (%) | 1,695 | 1,556 (24.7) | 139 (20.5) | 1,327 (24.8) | 368 (22.7) | ||
Age |
n
= 6,303
|
n
= 678
|
<0.001
|
n
= 5,360
|
n
= 1,621
|
<0.001
| |
≤40 years, n (%) | 73 | 66 (1.1) | 7 (1.0) | 61 (1.1) | 12 (0.7) | ||
41-50 years, n (%) | 536 | 502 (8.0) | 34 (5.0) | 448 (8.4) | 88 (5.4) | ||
51-60 years, n (%) | 1,876 | 1,730 (27.5) | 146 (21.5) | 1,519 (28.3) | 357 (22.0) | ||
61-70 years, n (%) | 2,053 | 1,865 (29.6) | 188 (27.7) | 1,612 (30.1) | 441 (27.2) | ||
71-80 years, n (%) | 1,713 | 1,530 (24.3) | 183 (27.0) | 1,260 (23.5) | 453 (28.0) | ||
>80 years, n (%) | 730 | 610 (9.7) | 120 (17.7) | 460 (8.6) | 270 (16.7) | ||
Age (years) |
n
= 6,303
|
n
= 678
|
<0.001
|
n
= 5,360
|
n
= 1,621
|
<0.001
| |
Mean (SD) | 65.2 (11.2) | 68.2 (11.7) | 64.7 (11) | 68.2 (11.7) | |||
Median (Q1-Q3) | 65 (57-74) | 68 (60-78) | 64 (57-73) | 68 (60-78) | |||
Body mass index (BMI; kg/m2) |
n
= 5,974
|
n
= 558
|
<0.001
|
n
= 5,139
|
n
= 1,393
|
<0.001
| |
Mean (SD) | 24.4 (4.8) | 23.5 (4.8) | 24.6 (4.8) | 23.3 (4.7) | |||
Median (Q1-Q3) | 23.9 (21-27.1) | 23.2 (20.3-26.3) | 24.1 (21.2-27.3) | 22.9 (20.1-26.1) | |||
Weight loss within the last 3 months |
n
= 6,154
|
n
= 625
|
<0.001
|
n
= 5,249
|
n
= 1,530
|
<0.001
| |
No, n (%) | 3,143 | 2,985 (48.5) | 158 (25.3) | 2,717 (51.8) | 426 (27.8) | ||
Yes, n (%) | 3,636 | 3,169 (51.5) | 467 (74.7) | 2,532 (48.2) | 1,104 (72.2) | ||
If yes |
n
= 3111
|
n
= 446
|
<0.001
|
n
= 2,493
|
n
= 1,064
|
<0.001
| |
<5 kg, n (%) | 1,489 | 1,340 (43.1) | 149 (33.4) | 1,141 (45.8) | 348 (32.7) | ||
5-10 kg, n (%) | 1,452 | 1,270 (40.8) | 182 (40.8) | 1,005 (40.3) | 447 (42.0) | ||
≥10 kg, n (%) | 616 | 501 (16.1) | 115 (25.8) | 347 (13.9) | 269 (25.3) | ||
Performance status at diagnosis |
n
= 6,235
|
n
= 672
|
<0.001
|
n
= 5,299
|
n
= 1,608
|
<0.001
| |
0- Fully active, n (%) | 1,885 | 1,855 (29.8) | 30 (4.5) | 1,765 (33.3) | 120 (7.5) | ||
1- Restricted in heavy physical work, n (%) | 2,872 | 2,749 (44.1) | 123 (18.3) | 2,462 (46.5) | 410 (25.5) | ||
2- Up and about more than half the day, n (%) | 1,273 | 1,103 (17.7) | 170 (25.3) | 812 (15.3) | 461 (28.7) | ||
3- In bed or sitting in a chair more than half the day, n (%) | 685 | 460 (7.4) | 225 (33.5) | 231 (4.4) | 454 (28.2) | ||
4- In bed or in a chair all the time, n (%) | 192 | 68 (1.1) | 124 (18.5) | 29 (0.6) | 163 (10.1) | ||
Smoking status |
n
= 6,271
|
n
= 668
|
0.831
|
n
= 5,335
|
n
= 1,604
|
0.803
| |
Never-smoker, n (%) | 752 | 679 (10.8) | 73 (10.9) | 583 (10.9) | 169 (10.5) | ||
Former-smoker, n (%) | 2,776 | 2,516 (40.1) | 260 (38.9) | 2,124 (39.8) | 652 (40.7) | ||
Active-smoker, n (%) | 3,411 | 3,076 (49.1) | 335 (50.2) | 2,628 (49.3) | 783 (48.8) | ||
Tobacco consumption (pack-years)b
|
5,893
|
n
= 5,352
|
n
= 541
|
0.003
|
n
= 4,566
|
n
= 1,327
|
<0.001
|
Mean (SD) | 42.8 (21.3) | 45.3 (22.4) | 42.5 (21) | 44.9 (22.8) | |||
Median (Q1-Q3) | 40 (30-50) | 40 (30-55) | 40 (30-50) | 40 (30-54) | |||
Tobacco duration (years)b
|
5,220
|
n
= 4,763
|
n
= 457
|
0.015
|
n
= 4,067
|
n
= 1,153
|
<0.001
|
Mean (SD) | 37.4 (11.6) | 38.7 (11.5) | 37.2 (11.6) | 38.5 (11.6) | |||
Median (Q1-Q3) | 40 (30-45) | 40 (30-46) | 39 (30-45) | 40 (30-45) |
Characteristics of the tumours according to patient’s vital status at 1 and 3 months
Vital status at | |||||||
---|---|---|---|---|---|---|---|
1 month | 3 months | ||||||
Alive | Dead | Alive | Dead | ||||
N
|
N = 6,303 |
N = 678 |
p-value
|
N = 5,360 |
N = 1,621 |
p-value
| |
Histology |
n
= 6,303
|
n
= 678
|
n
= 5,360
|
n
= 1,621
| |||
Small-cell carcinoma, n (%) | 961 | 829 (13.2) | 132 (19.5) |
<0.001
| 725 (13.5) | 236 (14.6) |
0.309
|
Adenocarcinoma, n (%) | 3,221 | 2,944 (46.7) | 277 (40.9) |
0.004
| 2,482 (46.3) | 739 (45.6) |
0.632
|
Squamous-cell carcinoma, n (%) | 1,875 | 1,733 (27.5) | 142 (20.9) |
<0.001
| 1,488 (27.8) | 387 (23.9) |
0.002
|
Large-cell carcinoma, n (%) | 786 | 665 (10.6) | 121 (17.9) |
<0.001
| 544 (10.2) | 242 (14.9) |
<0.001
|
Adenocarcinoma in situ, n (%) | 77 | 72 (1.1) | 5 (0.7) |
0.444
| 67 (1.3) | 10 (0.6) |
0.045
|
Carcinoid tumour, n (%) | 40 | 39 (0.6) | 1 (0.2) |
0.176
b
| 38 (0.7) | 2 (0.1) |
0.011
|
Other, n (%) | 111 | 102 (1.6) | 9 (1.3) |
0.679
| 86 (1.6) | 25 (1.5) |
0.095
|
Genomic mutation |
n
= 6,237
|
n
= 670
|
n
= 5,301
|
n
= 1,606
| |||
Explored, n (%) | 2,111 | 1,969 (31.6) | 142 (21.2) |
<0.001
|
1,685 (31.8)
| 426 (26.5) |
<0.001
|
If explored, |
n
= 1806
|
n
= 121
|
n
= 1,555
|
n
= 372
| |||
EGFR mutated, n (%) | 202 | 196 (10.9) | 6 (5.0) |
0.058
| 179 (11.5) | 23 (6.2) |
0.003
|
Stage (7 edition) |
n
= 6,264
|
n
= 672
|
<0.001
|
n
= 5,334
|
n
= 1,602
|
<0.001
| |
Stage ≤ IIB, n (%) | 1,129 | 1,100 (17.6) | 29 (4.3) | 1,056 (19.8) | 73 (4.6) | ||
Stage IIIA, n (%) | 934 | 905 (14.4) | 29 (4.3) | 845 (15.8) | 89 (5.6) | ||
Stage IIIB, n (%) | 705 | 643 (10.3) | 62 (9.2) | 571 (10.7) | 134 (8.4) | ||
Stage IV, n (%) | 4,168 | 3,616 (57.7) | 552 (82.1) | 2,862 (53.7) | 1,306 (81.5) |
Independent risk factors of early death
1 month | 3 months | ||||||
---|---|---|---|---|---|---|---|
OR | 95 % CI | OR | 95 % CI | ||||
N
| [Lower bound; Upper bound] |
p-value
| [Lower bound; Upper bound] |
p-value
| |||
Age | |||||||
≤50 years | 1 | ||||||
51-70 years | 1.18 | [0.89; 1.59] |
0.267
| ||||
>70 years | 1.51 | [1.11; 2.08] |
0.011
| ||||
Sex | |||||||
Men | 4,179 | 1 | 1 | ||||
Women | 1,369 | 0.69 | [0.52; 0.9] |
0.007
| 0.86 | [0.71; 1.04] |
0.129
|
Weight loss within the 3 preceding months | |||||||
No | 2,545 | 1 | 1 | ||||
Yes | 3,003 | 1.4 | [1.09; 1.81] |
0.01
| 1.54 | [1.3; 1.82] |
<0.001
|
Smoking status | |||||||
Never-smoker | 1 | ||||||
Former-smoker | 1.38 | [1.05; 1.83] |
0.024
| ||||
Active-smoker | 1.36 | [1.03; 1.81] |
0.031
| ||||
Performance status at diagnosis | |||||||
0- Fully active | 1,576 | 1 | 1 | ||||
1- Restricted in heavy physical work | 2,362 | 2 | [1.27; 3.28] |
0.004
| 1.82 | [1.43; 2.34] |
<0.001
|
2- Up and about more than half the day | 1,002 | 6.5 | [4.14; 10.63] |
<0.001
| 5.07 | [3.92; 6.6] |
<0.001
|
3- In bed or sitting in a chair more than half the day | 496 | 20.2 | [12.84; 33.15] |
<0.001
| 17.27 | [12.93; 23.25] |
<0.001
|
4- In bed or in a chair all the time | 112 | 71.9 | [41; 130.28] |
<0.001
| 44.23 | [26.29; 77.66] |
<0.001
|
Stage (7 edition) | |||||||
Stage ≤ IIB | 901 | 1 | 1 | ||||
Stage IIIA | 759 | 0.75 | [0.38; 1.46] |
0.397
| 1.17 | [0.79; 1.74] |
0.436
|
Stage IIIB | 570 | 2.17 | [1.24; 3.88] |
0.008
| 2.44 | [1.68; 3.56] |
<0.001
|
Stage IV | 3,318 | 2.36 | [1.49; 3.92] |
<0.001
| 3.66 | [2.72; 5.02] |
<0.001
|
Histology | |||||||
Adenocarcinoma | 2,521 | 1 | 1 | ||||
Small-cell carcinoma | 758 | 1.39 | [1.03; 1.87] |
0.032
| 0.73 | [0.58; 0.92] |
0.008
|
Squamous-cell carcinoma | 1,440 | 0.89 | [0.66; 1.2] |
0.454
| 0.91 | [0.75; 1.11] |
0.348
|
Large-cell carcinoma | 586 | 1.72 | [1.23; 2.38] |
0.001
| 1.33 | [1.04; 1.68] |
0.022
|
Adenocarcinoma in situ
| 48 | 2.05 | [0.45; 6.43] |
0.275
| 1.59 | [0.62; 3.64] |
0.298
|
Carcinoid tumour | 78 | 1.01 | [0.36; 2.45] |
0.983
| 1.01 | [0.5; 1.95] |
0.983
|
Other | 117 | 1.44 | [0.58; 3.13] |
0.396
| 1.17 | [0.63; 2.06] |
0.601
|
Characteristics of the first therapeutic strategy according to patient’s vital status and in dead patients at 1 and 3 months
Vital status at | ||||||
---|---|---|---|---|---|---|
1 month | 3 months | |||||
Alive | Dead | Alive | Dead | |||
N = 6,303 |
N = 678 |
p-value
|
N = 5,360 |
N = 1,621 |
p-value
| |
At least one therapy |
n
= 6,303
|
n
= 678
|
n
= 5,360
|
n
= 1,621
| ||
Yes, n (%) | 6,177 (98.0) | 559 (82.4) | 5,273 (98.4) | 1,463 (90.3) | ||
<0.001
|
<0.001
| |||||
No, n (%) | 126 (2.0) | 119 (17.6) | 87 (1.6) | 158 (19.7) | ||
At least one cancer therapy |
n
= 6,303
|
n
= 678
|
n
= 5,360
|
n
= 1,621
| ||
Yes, n (%) | 5,789 (91.8) | 241 (35.5) | 5,102 (95.2) | 928 (57.2) | ||
<0.001
|
<0.001
| |||||
No, n (%) | 514 (8.2) | 437 (64.5) | 258 (4.8) | 693 (42.8) | ||
At least one cancer therapy, exclusively |
n
= 6,303
|
n
= 678
|
n
= 5,360
|
n
= 1,621
| ||
Yes, n (%) | 5,740 (91.1) | 225 (33.2) | 5,084 (94.9) | 881 (54.3) | ||
<0.001
|
<0.001
| |||||
No, n (%) | 563 (8.9) | 453 (66.8) | 276 (5.1) | 740 (45.7) | ||
Included in a therapeutic trial |
n
= 6,303
|
n
= 678
|
n
= 5,360
|
n
= 1,621
| ||
Yes, n (%) | 221 (3.5) | 2 (0.3) | 209 (3.9) | 14 (0.9) | ||
<0.001
|
<0.001
| |||||
No, n (%) | 6,082 (96.5) | 676 (99.7) | 5,151 (96.1) | 1,607 (99.1) | ||
Multidisciplinary meeting |
n
= 6,296
|
n
= 671
|
n
= 5,355
|
n
= 1,612
| ||
Yes, n (%) | 6,011 (95.5) | 488 (72.7) | 5,139 (96.0) | 1,360 (84.4) | ||
<0.001
|
<0.001
| |||||
No, n (%) | 285 (4.5) | 183 (27.3) | 216 (4.0) | 252 (15.6) |
Characteristics of patients without cancer therapy
Vital status at | |||||||
---|---|---|---|---|---|---|---|
1 month | 3 months | ||||||
Alive | Dead | Alive | Dead | ||||
N |
N = 514 |
N = 437 |
p-value
|
N = 258 |
N = 693 |
p-value
| |
Sex |
n
= 514
|
n
= 437
|
0.071
|
n
= 258
|
n
= 693
|
0.911
| |
Men, n (%) | 733 | 384 (74.7) | 349 (79.9) | 200 (77.5) | 533 (76.9) | ||
Women, n (%) | 218 | 130 (25.3) | 88 (20.1) | 58 (22.5) | 160 (23.1) | ||
Age |
n
= 514
|
n
= 437
|
<0.001
c
|
n
= 258
|
n
= 693
|
<0.001
| |
≤40 years, n (%) | 1 | 0 (0) | 1 (0.2) | 0 (0) | 1 (0.1) | ||
41-50 years, n (%) | 31 | 14 (2.7) | 17 (3.9) | 4 (1.6) | 27 (3.9) | ||
51-60 years, n (%) | 135 | 54 (10.5) | 81 (18.5) | 24 (9.3) | 111 (16.0) | ||
61-70 years, n (%) | 216 | 101 (19.6) | 115 (26.3) | 46 (17.8) | 170 (24.5) | ||
71-80 years, n (%) | 302 | 179 (34.8) | 123 (28.1) | 101 (39.1) | 201 (29.0) | ||
>80 years, n (%) | 266 | 166 (32.3) | 100 (22.9) | 83 (32.2) | 183 (26.4) | ||
Age |
n
= 514
|
n
= 437
|
<0.001
|
n
= 258
|
n
= 693
|
<0.001
| |
Mean (SD) | 74.2 (10.9) | 70.1 (11.4) | 75 (9.9) | 71.3 (11.7) | |||
Median (Q1-Q3) | 76.5 (67-82) | 71 (61-80) | 77 (69-82) | 72 (62-81) | |||
Body mass index (BMI; kg/m2) |
n
= 414
|
n
= 337
|
0.863
|
n
= 221
|
n
= 530
|
0.015
| |
Mean (SD) | 23.6 (5.1) | 23.5 (4.7) | 24.4 (5.4) | 23.2 (4.6) | |||
Median (Q1-Q3) | 23.1 (20.1-26.8) | 23.4 (20.2-26.4) | 24 (20.6-27.4) | 23 (19.9-26.2) | |||
Weight loss within the last 3 months |
n
= 490
|
n
= 394
|
<0.001
|
n
= 249
|
n
= 635
|
<0.001
| |
No, n (%) | 279 | 183 (37.3) | 96 (24.4) | 115 (46.2) | 164 (25.8) | ||
Yes, n (%) | 605 | 307 (62.7) | 298 (75.6) | 134 (53.8) | 471 (74.2) | ||
If yes, |
n = 298
|
n = 282
|
0.224
|
n = 130
|
n = 450
|
0.010
| |
<5 kg, n (%) | 193 | 108 (36.2) | 85 (30.1) | 56 (43.1) | 137 (30.4) | ||
5-10 kg, n (%) | 233 | 118 (39.6) | 115 (40.8) | 56 (43.1) | 177 (39.3) | ||
≥10 kg, n (%) | 154 | 72 (24.2) | 82 (29.1) | 18 (13.8) | 136 (30.2) | ||
Performance status at diagnosis |
n
= 511
|
n
= 433
|
<0.001
|
n
= 255
|
n
= 689
|
<0.001
| |
0- Fully active, n (%) | 65 | 54 (10.6) | 11 (2.5) | 42 (16.5) | 23 (3.3) | ||
1- Restricted in heavy physical work, n (%) | 179 | 120 (23.5) | 59 (13.6) | 78 (30.6) | 101 (14.7) | ||
2- Up and about more than half the day, n (%) | 221 | 127 (24.8) | 94 (21.7) | 59 (23.1) | 162 (23.5) | ||
3- In bed or sitting in a chair more than half the day, n (%) | 336 | 174 (34.1) | 162 (37.4) | 63 (24.7) | 273 (39.6) | ||
4- In bed or in a chair all the time, n (%) | 143 | 36 (7.0) | 107 (24.7) | 13 (5.1) | 130 (18.9) | ||
Smoking status |
n
= 505
|
n
= 427
|
0.389
|
n
= 252
|
n
= 680
|
0.174
| |
Never-smoker, n (%) | 121 | 69 (13.7) | 52 (12.2) | 37 (14.7) | 84 (12.4) | ||
Former-smoker, n (%) | 399 | 223 (44.2) | 176 (41.2) | 116 (46.0) | 283 (41.6) | ||
Active smoker, n (%) | 412 | 213 (42.2) | 199 (46.6) | 99 (39.3) | 313 (46.0) | ||
Tobacco consumption (pack-years) b
|
n
= 394
|
n
= 331
|
0.822
|
n
= 198
|
n
= 527
|
0.025
| |
Mean (SD) | 47.2 (26.3) | 46.1 (22.4) | 50 (27.3) | 45.5 (23.4) | |||
Median (Q1-Q3) | 45 (30-60) | 42 (30-59) | 50 (30-60) | 42 (30-55) | |||
Tobacco duration (years) b
|
n
= 340
|
n
= 280
|
0.016
|
n
= 172
|
n
= 448
|
0.012
| |
Mean (SD) | 41.9 (13.5) | 39.7 (12) | 42.9 (14.1) | 40.1 (12.3) | |||
Median (Q1-Q3) | 40 (31.8-50) | 40 (30-50) | 43 (35-50) | 40 (30-50) | |||
Histology |
n
= 514
|
n
= 437
|
n
= 258
|
n
= 693
| |||
Small-cell carcinoma, n (%) | 101 | 26 (5.1) | 75 (17.2) |
<0.001
| 5 (1.94) | 96 (13.9) |
<0.001
|
Adenocarcinoma, n (%) | 394 | 215 (41.8) | 179 (41.0) |
0.838
| 96 (37.2) | 298 (43.0) |
0.124
|
Squamous-cell carcinoma, n (%) | 297 | 201 (39.1) | 96 (22.0) |
<0.001
| 117 (45.4) | 180 (26.0) |
<0.001
|
Large-cell carcinoma, n (%) | 155 | 70 (13.6) | 85 (19.5) |
0.019
| 38 (14.7) | 117 (16.9) |
0.483
|
Adenocarcinoma in situ, n (%) | 5 | 2 (0.4) | 3 (0.7) |
0.855
| 2 (0.8) | 3 (0.4) |
0.885
c
|
Carcinoid tumour, n (%) | 3 | 2 (0.4) | 1 (0.2) |
1.000
c
| 1 (0.4) | 2 (0.3) |
1.000
c
|
Other, n (%) | 11 | 7 (1.4) | 4 (0.9) |
0.736
| 3 (1.2) | 8 (1.2) |
1.000
c
|
Genomic mutation |
n
= 508
|
n
= 430
|
n
= 254
|
n
= 684
| |||
Explored, n (%) | 195 | 110 (21.7) | 85 (19.8) |
0.530
| 55 (21.7) | 140 (20.5) |
0759
|
If explored, |
n
= 102
|
n
= 76
|
n
= 50
|
n
= 128
| |||
EGFR mutated, n (%) | 12 | 8 (7.84) | 4 (5.26) |
0.706
| 4 (8) | 8 (6.3) |
0.932
|
Stage (7 edition) |
n
= 502
|
n
= 432
|
<0.001
|
n
= 252
|
n
= 682
|
<0.001
| |
Stage ≤ IIB, n (%) | 94 | 79 (15.7) | 15 (3.5) | 65 (25.8) | 29 (4.3) | ||
Stage IIIA, n (%) | 99 | 75 (15.0) | 24 (5.6) | 50 (19.8) | 49 (7.2) | ||
Stage IIIB, n (%) | 88 | 51 (10.2) | 37 (8.6) | 33 (13.1) | 55 (8.1) | ||
Stage IV, n (%) | 653 | 297 (59.2) | 356 (82.4) | 104 (41.3) | 549 (80.5) |