Important prognostic factors for the long-term survival of lung cancer subjects in Taiwan
1 Department of Medical Technology, College of Medicine and Life Science, Chung-Hwa University of Medical Technology, Tainan, Taiwan
2 Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Taiwan
3 Department of Occupational Safety and Hygiene, Tajen University, Pingtung, Taiwan
4 Faculty of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
5 Department of Healthcare Administration, Tajen University, Pingtung, Taiwan
6 Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
7 Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
8 Department of Public Health, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
BMC Cancer 2008, 8:324 doi:10.1186/1471-2407-8-324Published: 7 November 2008
This study used a large-scale cancer database in determination of prognostic factors for the survival of lung cancer subjects in Taiwan.
Total of 24,910 subjects diagnosed with lung cancer was analysed. Survival estimates by Kaplan-Meier methods. Cox proportional-hazards model estimated the death risk (hazard ratio (HR)) for various prognostic factors.
The prognostic indicators associated with a higher risk of lung cancer deaths are male gender (males versus females; HR = 1.07, 95% confidence intervals (CI): 1.03–1.11), males diagnosed in later periods (shown in 1991–1994 versus 1987–1990; HR = 1.13), older age at diagnosis, large cell carcinoma (LCC)/small cell carcinoma (SCC), and supportive care therapy over chemotherapy. The overall 5-year survival rate for lung cancer death was significantly poorer for males (21.3%) than females (23.6%). Subjects with squamous cell carcinoma (SQCC) and treatment by surgical resection alone had better prognosis. We find surgical resections to markedly increase 5-year survival rate from LCC, decreased risk of death from LCC, and no improved survival from SCC.
Gender and clinical characteristics (i.e. diagnostic period, diagnostic age, histological type and treatment modality) play important roles in determining lung cancer survival.