C Dickhoff1, M Dahele2, E F Smit3, M A Paul4, S Senan5, K J Hartemink6, R A Damhuis7. 1. Departments of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands; Departments of Cardiothoracic Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. Electronic address: c.dickhoff@vumc.nl. 2. Departments of Radiation Oncology, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. Electronic address: m.dahele@vumc.nl. 3. Departments of Pulmonary Diseases, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands; Departments of Thoracic Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands. Electronic address: ef.smit@vumc.nl. 4. Departments of Cardiothoracic Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. Electronic address: ma.paul@vumc.nl. 5. Departments of Radiation Oncology, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. Electronic address: s.senan@vumc.nl. 6. Departments of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands. Electronic address: kj.hartemink@hetnet.nl. 7. Department of Research, Netherlands Comprehensive Cancer Organisation, P.O. Box 19079, 3501 DB, Utrecht, The Netherlands. Electronic address: r.damhuis@iknl.nl.
Abstract
OBJECTIVES: There is limited data on the pattern of care for locally advanced, clinical (c) IIIB non-small cell lung cancer (NSCLC) in the TNM-7 staging era. The primary aim of this study was to investigate national patterns of care and outcomes in the Netherlands, with a secondary focus on the use of surgery. MATERIAL AND METHODS: Data from patients treated for TNM-7 cIIIB NSCLC between 2010 and 2014, was extracted from the Netherlands Cancer Registry (NCR). Survival data was obtained from the automated Civil Registry. RESULTS: 43.762 patients with NSCLC were recorded in the NCR during this 5-year period, with cIIIB accounting for 10% (n=4.401). Clinical N2 (37%) and N3 (63%) nodal involvement was pathologically confirmed in 50.8%. The use of endobronchial ultrasound (EBUS) increased with time from 9% to 29% (p<0.001), while the rate of pathological confirmation of N2 or N3 nodes increased from 44% to 54% (p<0.001). 48% of patients received chemoradiotherapy (CRT), 19% chemotherapy (CT), RT in 10% and surgery in 2.2%. 22% received best supportive care (BSC). The percentage of patients treated with CRT decreased from 65% for patients aged <60 years to 13% for patients aged 80 years or older. Overall survival for surgery was 28 months, followed by CRT (19mths), CT (9mths), RT (8mths) and BSC (3mths). CONCLUSION: In the Netherlands, CRT is the most frequent treatment for cIIIB NSCLC in the TNM-7 era. The use of surgery is limited. Accurate staging requires specific attention and the scarce use of radical treatment in elderly patients merits further evaluation.
OBJECTIVES: There is limited data on the pattern of care for locally advanced, clinical (c) IIIB non-small cell lung cancer (NSCLC) in the TNM-7 staging era. The primary aim of this study was to investigate national patterns of care and outcomes in the Netherlands, with a secondary focus on the use of surgery. MATERIAL AND METHODS: Data from patients treated for TNM-7 cIIIBNSCLC between 2010 and 2014, was extracted from the Netherlands Cancer Registry (NCR). Survival data was obtained from the automated Civil Registry. RESULTS: 43.762 patients with NSCLC were recorded in the NCR during this 5-year period, with cIIIB accounting for 10% (n=4.401). Clinical N2 (37%) and N3 (63%) nodal involvement was pathologically confirmed in 50.8%. The use of endobronchial ultrasound (EBUS) increased with time from 9% to 29% (p<0.001), while the rate of pathological confirmation of N2 or N3 nodes increased from 44% to 54% (p<0.001). 48% of patients received chemoradiotherapy (CRT), 19% chemotherapy (CT), RT in 10% and surgery in 2.2%. 22% received best supportive care (BSC). The percentage of patients treated with CRT decreased from 65% for patients aged <60 years to 13% for patients aged 80 years or older. Overall survival for surgery was 28 months, followed by CRT (19mths), CT (9mths), RT (8mths) and BSC (3mths). CONCLUSION: In the Netherlands, CRT is the most frequent treatment for cIIIBNSCLC in the TNM-7 era. The use of surgery is limited. Accurate staging requires specific attention and the scarce use of radical treatment in elderly patients merits further evaluation.
Authors: Michael C Tjong; Nauman H Malik; Hanbo Chen; R Gabriel Boldt; George Li; Patrick Cheung; Ian Poon; Yee C Ung; May Tsao; Alexander V Louie Journal: J Thorac Dis Date: 2020-05 Impact factor: 2.895
Authors: Isabel F Remmerts de Vries; Merle I Ronden; Idris Bahce; Femke O B Spoelstra; Patricia F De Haan; Cornelis J A Haasbeek; Birgit I Lissenberg-Witte; Ben J Slotman; Max Dahele; Wilko F A R Verbakel Journal: Cancers (Basel) Date: 2021-11-25 Impact factor: 6.639