Temporal Trends in Demographics and Overall Survival of Non-Small-Cell Lung Cancer Patients at Moffitt Cancer Center From 1986 to 2008

Background: An assessment of historical trends in patient survival is important to determine the progress toward patient outcomes and to reveal where advancements must be made. The goal of this study was to assess changes in demographics and overall survival of non-small-cell lung cancer (NSCLC) patients who were seen at Moffitt Cancer Center spanning 22 years. Methods: This analysis included 4,997 NSCLC patients who were treated at our institute over 5 time periods: 1986 to 1988, 1991 to 1993, 1996 to 1998, 2001 to 2003, and 2006 to 2008. Kaplan-Meier survival curves and the log-rank statistic were used to assess changes in 5-year survival rates over the 5 time periods, and multivariable hazard ratios were estimated from Cox proportional hazards models. Results: From 1986 to 2008 we observed statistically significant increases in the percentage of patients over the age of 70 years, women, never-smokers and former smokers, and patients with stage I tumors. Over the same time period the median survival time statistically significantly increased from 1.09 years (95% confidence interval [CI], 0.95-1.34, P < .001) to 2.27 years (95% CI, 2.07-2.46, P < .001), and the overall 5-year survival rate for all patients significantly increased from 14.7% to 31.1% (P < .001). Among stage I patients, the 5-year survival rate increased from 31.7% to 54.0% (P < .001), 13.3% to 36.0% for stage II (P < .001), 10.5% to 21.7% for stage III (P < .001), and 3.4% to 9.6% for stage IV (P < .001). Conclusions: This analysis demonstrated important temporal changes in the demographics and improvements in overall survival of NSCLC patients treated at our institute from 1986 to 2008. The 5-year survival rates and median survival time of patients diagnosed with NSCLC has significantly improved across all stages, including patients with late-stage disease.