Background
Methods
Patients
Patient-level analysis and cost estimation
Statistical analysis
Results
Patient characteristics and survival
NSCLC | SCLC | NCC | Total | |
---|---|---|---|---|
N
|
172
|
26
|
34
|
232
|
Age (years), mean | 65.4 | 67.3 | 72.7 | 66.7 |
Gender (%)
| ||||
Male | 84.9 | 88.5 | 73.5 | 83.6 |
Female | 15.1 | 11.5 | 26.5 | 16.4 |
TNM Stage (%)
| ||||
I | 22.7 | - | 5.9 | - |
II | 6.4 | - | - | - |
III | 20.9 | - | 11.8 | - |
IV | 41.3 | - | 47.1 | - |
Limited disease | - | 26.9 | - | - |
Extensive disease | - | 61.5 | - | - |
Unknown | 8.7 | 11.5 | 35.3 | - |
Surgery (%)
|
34.9
|
-
|
11.8
|
27.6
|
Partial lobectomy | 3.3 | - | 25.0 | 4.6 |
Lobectomy | 59. | - | 75.0 | 60.0 |
Bilobectomy | 11.5 | - | - | 10.8 |
Pneumonectomy | 9.8 | - | - | 9.2 |
Exploratory thoracotomy | 8.2 | - | - | 7.7 |
Others | 8.2 | - | - | 7.7 |
Chemotherapy (%)
|
53.5
|
80.8
|
20.6
|
51.7
|
Intention
| ||||
Neoadjuvant | 3.0 | - | - | 2.2 |
Adjuvant | 5.9 | - | - | 4.5 |
Radical | 8.8 | 25.9 | - | 11.2 |
Palliative | 45.2 | 41.9 | 46.2 | 44.7 |
Unknown | 37.0 | 32.3 | 53.8 | 37.4 |
Treatment scheme
| ||||
Cisplatin/Carboplatin + Docetaxel | 5.9 | - | 7.7 | 5.0 |
Cisplatin/Carboplatin + Etoposide | 6.7 | 67.7 | - | 16.8 |
Cisplatin/Carboplatin + Gemcitabine | 23.7 | - | 7.7 | 18.4 |
Cisplatin/Carboplatin + Paclitaxel | 6.7 | 3.2 | 15.4 | 6.7 |
Cisplatin/Carboplatin + Pemetrexed | 5.9 | - | 7.7 | 5.0 |
Cisplatin/Carboplatin + Vinorelbine | 16.3 | - | 7.7 | 12.8 |
Docetaxel | 4.4 | - | 7.7 | 3.9 |
Erlotinib | 11.9 | 3.2 | 15.4 | 10.6 |
Pemetrexed | 8.1 | - | 15.4 | 7.3 |
Others | 10.3 | 25.8 | 15.4 | 13.4 |
Radiotherapy (%)
|
35.5
|
69.2
|
8.8
|
35.3
|
Radical | 31.0 | 20.8 | 0.0 | 26.8 |
Palliative | 53.5 | 50.0 | 83.3 | 54.4 |
Unknown | 15.5 | 29.2 | 16.7 | 18.8 |
N | Deaths N (%) | Survival time (months) Median | Survival time (months) Mean [sd] | Follow-up time (months) Mean [sd] | |
---|---|---|---|---|---|
NSCLC
| |||||
Stage I | 39 | 6 (15.4) | - | 36.3 [2.2] | 21.2 [13.1] |
Stage II | 11 | 3 (27.3) | - | 32.1 [3.9] | 21.5 [13.3] |
Stage III | 36 | 17 (47.2) | 16.0 | 18.9 [2.8] | 11.9 [11.4] |
Stage IV | 71 | 44 (62.0) | 4.9 | 10.7 [1.9] | 5.6 [7.9] |
Unknown | 15 | 5 (33.3) | - | 20.1 [4.5] | 10.1 [12.1] |
Total
|
172
|
75 (43.6)
|
18.0
|
22.8 [1.6]
|
11.9 [12.5]
|
SCLC
| |||||
Limited disease | 7 | 4 (57.1) | 10.9 | 17.0 [3.6] | 12.6 [7.1] |
Extensive disease | 16 | 13 (81.3) | 8.6 | 9.4 [2.5] | 8.4 [9.1] |
Unknown | 3 | 2 (66.7) | 1.1 | 1.3 [0.4] | 1.3 [1.0] |
Total
|
26
|
19 (73.1)
|
8.9
|
11.8 [2.6]
|
8.7 [8.5]
|
NCC
| |||||
Stage I | 2 | 0 (0.0) | - | - | 36.3 [0.2] |
Stage II | - | - | - | - | - |
Stage III | 4 | 2 (50.0) | - | - | 11.9 [13.6] |
Stage IV | 16 | 11 (68.8) | - | - | 4.8 [8.7] |
Unknown | 12 | 3 (25.0) | - | - | 1.8 [2.1] |
Total
|
34
|
16 (47.1)
|
-
|
-
|
6.4 [10.9]
|
Cost estimation
Diagnosis | Surgery | Chemotherapy | Radiotherapy | Other inpatient care | Continuing care | Total cost | |
---|---|---|---|---|---|---|---|
NSCLC (sum, %)
| |||||||
Stage I | 28,573 | 306,114 | 27,280 | 12,755 | 102,652 | 42,153 |
519,526
|
5.5% | 58.9% | 5.3% | 2.5% | 19.8% | 8.1% | 100.0% | |
Stage II | 16,106 | 81,416 | 27,624 | 6,538 | 32,288 | 13,348 |
177,320
|
9.1% | 45.9% | 15.6% | 3.7% | 18.2% | 7.5% | 100.0% | |
Stage III | 119,463 | 71,598 | 98,958 | 25,969 | 128,901 | 30,957 |
475,846
|
25.1% | 15.0% | 20.8% | 5.5% | 27.1% | 6.5% | 100.0% | |
Stage IV | 287,012 | 22,863 | 488,195 | 23,205 | 227,928 | 18,930 |
1,068,133
|
26.9% | 2.1% | 45.7% | 2.2% | 21.3% | 1.8% | 100.0% | |
Unknown | 71,792 | 98,615 | 111,030 | 900 | 15,828 | 9,670 |
307,835
|
23.3% | 32.0% | 36.1% | 0.3% | 5.1% | 3.1% | 100.0% | |
Total (N = 172)
|
522,946
|
580,605
|
753,087
|
69,367
|
507,597
|
115,058
|
2,548,661
|
20.5% | 22.8% | 29.5% | 2.7% | 19.9% | 4.5% | 100.0% | |
SCLC (sum, %)
| |||||||
Limited disease | 11,822 | - | 33,959 | 11,699 | 42,933 | 7,516 |
107,929
|
11.0% | 31.5% | 10.8% | 39.8% | 7.0% | 100.0% | ||
Extensive disease | 45,011 | - | 83,077 | 10,928 | 48,729 | 11,962 |
199,707
|
22.5% | 41.6% | 5.5% | 24.4% | 6.0% | 100.0% | ||
Unknown | 14,584 | - | 67 | - | 1,266 | 526 |
16,444
|
88.7% | 0.4% | 7.7% | 3.2% | 100.0% | |||
Total (N = 26)
|
71,417
|
-
|
117,103
|
22,627
|
92,928
|
20,005
|
324,079
|
22.0% | 36.1% | 7.0% | 28.7% | 6.2% | 100.0% | ||
NCC (sum, %)
| |||||||
Stage I | 2,195 | 16,844 | - | - | 83,428 | 701 |
103,168
|
2.1% | 16.3% | 80.9% | 0.7% | 100.0% | |||
Stage II | - | - | - | - | - | - |
-
|
Stage III | 8,122 | - | 7,400 | - | 5,875 | 1,880 |
23,277
|
34.9% | 31.8% | 25.2% | 8.1% | 100.0% | |||
Stage IV | 58,543 | 7,835 | 81,106 | 4,747 | 32,462 | 2,973 |
187,665
|
31.2% | 4.2% | 43.2% | 2.5% | 17.3% | 1.6% | 100.0% | |
Unknown | 62,873 | 10,660 | 2,335 | - | 20,794 | 1,698 |
98,360
|
63.9% | 10.8% | 2.4% | 21.1% | 1.7% | 100.0% | ||
Total (N = 34)
|
131,734
|
35,339
|
90,841
|
4,747
|
142,559
|
7,252
|
412,472
|
31.9% | 8.6% | 22.0% | 1.2% | 34.6% | 1.8% | 100.0% |
Diagnosis | Surgery | Chemotherapy | Radiotherapy | Other inpatient care | Continuing care | Total mean cost | p-value | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NSCLC (mean, [sd], %) | |||||||||||||||
Male
| 2,998 | [3,264] | 3,272 | [4,838] | 3,261 | [8,354] | 432 | [785] | 2,982 | [4,805] | 678 | [910] | 13,624 | [10,649] | 0.072 |
(N = 146) | 22.0% | 24.0% | 23.9% | 3.2% | 21.9% | 5.0% | 100.0% | ||||||||
Female
| 3,277 | [3,089] | 3,955 | [5,542] | 10,654 | [19,139] | 242 | [595] | 2,777 | [4,738] | 616 | [979] | 21,521 | [19,367] | |
(N = 26) | 15.2% | 18.4% | 49.5% | 1.1% | 12.9% | 2.9% | 100% | ||||||||
<65 years
| 2,880 | [3,058] | 3,436 | [5,338] | 4,890 | [10,060] | 403 | [740] | 2,981 | [5,078] | 679 | [906] | 15,270 | [12,600] | 0.716 |
(N = 76) | 18.9% | 22.5% | 32.0% | 2.6% | 19.5% | 4.4% | 100.0% | ||||||||
≥65 years
| 3,167 | [3,372] | 3,327 | [4,628] | 3,973 | [11,634] | 403 | [781] | 2,928 | [4,561] | 661 | [932] | 14,460 | [12,674] | |
(N = 96) | 21.9% | 23.0% | 27.5% | 2.8% | 20.2% | 4.6% | 100.0% | ||||||||
Stage I
| 733 | [551] | 7,849 | [4,515] | 699 | [2,179] | 327 | [745] | 2,632 | [5,285] | 1,081 | [864] | 13,321 | [8,316] | 0.289 |
(N = 39) | 5.5% | 58.9% | 5.2% | 2.5% | 19.8% | 8.1% | 100.0% | ||||||||
Stage II
| 1,464 | [1,131] | 7,401 | [4,898] | 2,511 | [4,887] | 594 | [811] | 2,935 | [4,142] | 1,213 | [1,333] | 16,120 | [7,632] | |
(N = 11) | 9.1% | 45.9% | 15.6% | 3.7% | 18.2% | 7.5% | 100.0% | ||||||||
Stage III
| 3,318 | [2,576] | 1,989 | [4,159] | 2,749 | [6,452] | 721 | [978] | 3,581 | [5,051] | 860 | [1,235] | 13,218 | [10,240] | |
(N = 36) | 25.1% | 15.0% | 20.8% | 5.5% | 27.1% | 6.5% | 100.0% | ||||||||
Stage IV
| 4,042 | [3,299] | 322 | [1,610] | 6,876 | [13,283] | 327 | [661] | 3,210 | [4,853] | 263 | [416] | 15,044 | [14,338] | |
(N = 71) | 26.9% | 2.1% | 45.7% | 2.2% | 21.3% | 1.7% | 100.0% | ||||||||
Unknown
| 4,786 | [5,423] | 6,574 | [6,133] | 7,402 | [18,928] | 60 | [232] | 1,055 | [2,059] | 645 | [833] | 20,522 | [19,336] | |
(N = 15) | 23.3% | 32.0% | 36.1% | 0.3% | 5.1% | 3.1% | 100.0% | ||||||||
Alive 1 year
| 2,644 | [3,138] | 4,814 | [5,372] | 4,427 | [10,847] | 472 | [812] | 2,661 | [4,477] | 938 | [1,038] | 15,955 | [12,202] | 0.002 |
(N = 106) | 16.6% | 30.2% | 27.7% | 3.0% | 16.7% | 5.9% | 100.0% | ||||||||
Dead 1 year
| 3,677 | [3,300] | 1,066 | [2,961] | 4,301 | [11,183] | 293 | [661] | 3,418 | [5,237] | 237 | [409] | 12,991 | [13,129] | |
(N = 66) | 28.3% | 8.2% | 33.1% | 2.3% | 26.3% | 1.8% | 100.0% | ||||||||
Total
| 3,040 | [3,231] | 3,376 | [4,939] | 4,378 | [10,945] | 403 | [761] | 2,951 | [4,782] | 669 | [918] | 14,818 | [12,611] | |
(N = 172) | 20.5% | 22.8% | 29.5% | 2.7% | 19.9% | 4.5% | 100.0% | ||||||||
SCLC (mean, [sd], %) | |||||||||||||||
Male
| 2,708 | [2,350] | - | 4,646 | [10,164] | 878 | [952] | 2,747 | [3,627] | 694 | [791] | 11,674 | [11,089] | 0.078 | |
(N = 23) | 23.2% | 39.8% | 7.5% | 23.5% | 5.9% | 100.0% | |||||||||
Female
| 3,041 | [1,905] | - | 3,412 | [2,889] | 814 | [912] | 9,915 | [8,846] | 1,345 | [1,272] | 18,527 | [9,054] | ||
(N = 3) | 16.4% | 18.4% | 4.4% | 53.5% | 7.3% | 100.0% | |||||||||
<65 years
| 2,159 | [1,993] | - | 7,361 | [13,510] | 1,114 | [981] | 5,580 | [6,000] | 1,080 | [930] | 17,294 | [14,093] | 0.006 | |
(N = 12) | 12.5% | 42.6% | 6.4% | 32.3% | 6.2% | 100.0% | |||||||||
≥65 years
| 3,251 | [2,443] | - | 2,055 | [2,824] | 661 | [864] | 1,855 | [2,726] | 503 | [706] | 8,325 | [4,718] | ||
(N = 14) | 39.1% | 24.7% | 7.9% | 22.3% | 6.0% | 100.0% | |||||||||
Limited disease
| 1,689 | [1,757] | - | 4,851 | [3,380] | 1,671 | [1,187] | 6,133 | [7,057] | 1,074 | [867] | 15,418 | [10,105] | 0.140 | |
(N = 7) | 11.0% | 31.5% | 10.8% | 39.8% | 7.0% | 100.0% | |||||||||
Extensive disease
| 2,813 | [2,175] | - | 5,192 | [11,989] | 683 | [624] | 3,046 | [3,672] | 748 | [888] | 12,482 | [12,007] | ||
(N = 16) | 22.5% | 41.6% | 5.5% | 24.4% | 6.0% | 100.0% | |||||||||
Unknown
| 4,861 | [3,018] | - | 22 | [39] | - | 422 | [731] | 175 | [208] | 5,481 | [2,378] | |||
(N = 3) | 88.7% | 0.4% | 7.7% | 3.2% | 100.0% | ||||||||||
Alive 1 year
| 2,388 | [2,047] | - | 2,976 | [2,784] | 1,436 | [1,093] | 1,431 | [2,652] | 1,086 | [1,008] | 9,316 | [3,443] | 0.597 | |
(N = 9) | 25.6% | 31.9% | 15.4% | 15.4% | 11.7% | 100.0% | |||||||||
Dead 1 year
| 2,937 | [2,420] | - | 5,313 | [11,724] | 571 | [692] | 4,709 | [5,378] | 602 | [735] | 14,131 | [13,140] | ||
(N = 17) | 20.8% | 37.6% | 4.0% | 33.3% | 4.3% | 100.0% | |||||||||
Total
| 2,747 | [2,272] | - | 4,504 | [9,578] | 870 | [930] | 3,574 | [4,826] | 769 | [852] | 12,465 | [10,943] | ||
(N = 26) | 22.0% | 36.1% | 7.0% | 28.7% | 6.2% | 100.0% | |||||||||
NCC (mean, [sd], %) | |||||||||||||||
Male
| 3,901 | [3,538] | 1,100 | [3,063] | 183 | [533] | 36 | [136] | 4,768 | [16,839] | 129 | [254] | 10,116 | [18,410] | 0.645 |
(N = 25) | 38.6% | 10.9% | 1.8% | 0.4% | 47.1% | 1.3% | 100.0% | ||||||||
Female
| 3,802 | [2,945] | 871 | [2,612] | 9,586 | [17,920] | 427 | [1,282] | 2,597 | [4,336] | 447 | [604] | 17,729 | [23,745] | |
(N = 9) | 21.4% | 4.9% | 54.1% | 2.4% | 14.6% | 2.5% | 100.0% | ||||||||
<65 years
| 2,961 | [3,609] | 3,085 | [4,261] | 10,040 | [19,035] | 513 | [1,350] | 14,563 | [28,241] | 293 | [476] | 31,455 | [34,191] | 0.009 |
(N = 8) | 9.4% | 9.8% | 31.9% | 1.6% | 46.3% | 0.9% | 100.0% | ||||||||
≥65 years
| 4,156 | [3,286] | 410 | [2,091] | 405 | [1,504] | 25 | [126] | 1,002 | [3,338] | 189 | [373] | 6,186 | [6,128] | |
(N = 26) | 67.2% | 6.6% | 6.5% | 0.4% | 16.2% | 3.1% | 100.0% | ||||||||
Stage I
| 1,098 | [998] | 8,422 | [0] | - | - | 41,714 | [58,992] | 350 | [496] | 51,584 | [59,495] | 0.231 | ||
(N = 2) | 2.1% | 16.3% | 80.9% | 0.7% | 100.0% | ||||||||||
Stage II
| - | - | - | - | - | - | - | ||||||||
(N = 0) | |||||||||||||||
Stage III
| 2,031 | [2,498] | - | 1,850 | [3,700] | - | 1,469 | [1,300] | 470 | [550] | 5,819 | [6,680] | |||
(N = 4) | 34.9% | 31.8% | 25.2% | 8.1% | 100.0% | ||||||||||
Stage IV
| 3,659 | [2,869] | 490 | [1,959] | 5,069 | [13,981] | 297 | [962] | 2,029 | [4,090] | 186 | [436] | 11,729 | [18,728] | |
(N = 16) | 31.2% | 4.2% | 43.2% | 2.5% | 17.3% | 1.6% | 100.0% | ||||||||
Unknown
| 5,239 | [3,984] | 888 | [3,077] | 195 | [674] | - | 1,733 | [4,840] | 142 | [261] | 8,197 | [7,585] | ||
(N = 12) | 64.1% | 10.8% | 2.4% | 21.1% | 1.7% | 100.0% | |||||||||
Alive 1 year
| 3,493 | [2,978] | 1,860 | [3,735] | 2,088 | [6,677] | 216 | [881] | 5,861 | [19,080] | 333 | [478] | 13,851 | [22,728] | 0.242 |
(N = 19) | 25.2% | 13.4% | 15.1% | 1.6% | 42.3% | 2.4% | 100.0% | ||||||||
Dead 1 year
| 4,358 | [3,816] | - | 3,411 | [12,939] | 43 | [166] | 2,080 | [4,734] | 62 | [171] | 9,954 | [16,042] | ||
(N = 15) | 43.8% | 34.3% | 0.4% | 20.9% | 0.6% | 100.0% | |||||||||
Total
| 3,875 | [3,348] | 1,039 | [2,914] | 2,672 | [9,787] | 140 | [666] | 4,193 | [14,550] | 213 | [394] | 12,132 | [19,869] | |
(N = 34) | 31.9% | 8.6% | 22.0% | 1.2% | 34.6% | 1.8% | 100.0% |
Surgical interventions | Chemotherapy treatments | Radiotherapy treatments | |||||||
---|---|---|---|---|---|---|---|---|---|
N | Mean cost (Euros) [sd] | N | Mean cost (Euros) [sd] | N | Mean cost (Euros) [sd] | ||||
NSCLC
| |||||||||
Stage I | 33 | 9,566 | [1,486] | 14 | 1,949 | [2,193] | 10 | 1,275 | [901] |
Stage II | 8 | 10,177 | [1,411] | 6 | 4,604 | [4,772] | 5 | 1,308 | [692] |
Stage III | 7 | 10,228 | [1,608] | 34 | 2,911 | [5,255] | 20 | 1,298 | [907] |
Stage IV | 3 | 7,621 | [2,707] | 68 | 7,179 | [12,465] | 35 | 663 | [683] |
Unknown | 10 | 9,862 | [1,419] | 7 | 15,861 | [23,014] | 1 | 900 | - |
Total
|
61
|
9,677
|
[1,585]
|
129
|
5,838
|
[11,185]
|
71
|
977
|
[825]
|
SCLC
| |||||||||
Limited disease | - | - | - | 11 | 3,087 | [2,732] | 12 | 975 | [733] |
Extensive disease | - | - | - | 19 | 4,372 | [11,056] | 12 | 911 | [430] |
Unknown | - | - | - | 1 | 67 | - | 0 | - | - |
Total
|
-
|
-
|
-
|
31
|
3,778
|
[8,757]
|
24
|
943
|
[589]
|
NCC
| |||||||||
Stage I | 2 | 8,422 | [0] | - | - | - | - | - | - |
Stage II | - | - | - | - | - | - | - | - | - |
Stage III | - | - | - | 3 | 2,467 | [3,378] | - | - | - |
Stage IV | 1 | 7,835 | - | 9 | 9,012 | [11,535] | 6 | 791 | [607] |
Unknown | 1 | 10,660 | - | 1 | 2,335 | - | - | - | - |
Total
|
4
|
8,835
|
[1,248]
|
13
|
6,988
|
[10,030]
|
6
|
791
|
[607]
|