https://doi.org/10.4081/monaldi.2024.3045
Survival among patients with lung cancer managed at a tertiary care center in North India
Submitted: May 2, 2024
Accepted: May 24, 2024
Published: July 26, 2024
Accepted: May 24, 2024
Abstract Views: 379
PDF_EARLY VIEW: 218
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Though there has been advancement in the management of lung cancer, it is not well utilized due to its limited availability and high cost. This is a prospective observational study done at a tertiary care center from January 2014 to December 2022, involving patients with primary lung cancer. After tumor-node-metastasis staging and molecular testing, the patients received chemotherapy, radiotherapy, surgery, targeted therapy, and immunotherapy in various combinations as per the prevailing National Comprehensive Cancer Network Guidelines. 92 patients were enrolled in the study, with the mean age being 58.94±10.33 and 72 (78.26%) being males. 69 (75%) patients were either current or former smokers. 78 (84.78%) patients had an Eastern Cooperative Oncology Group (ECOG) score of 0-2 while the remaining had an ECOG of 3-4. 80 (86.95%) patients had non-small cell lung cancer (NSCLC) [44 (47.83%) adenocarcinoma, 25 (27.17%) squamous cell carcinoma, and 11 (11.95%) NSCLC: not otherwise specified], while 12 (13.04%) patients had small cell lung cancer. One (1.08%) patient each presented in stage I and stage II, 31 (33.69%) patients presented in stage III, and 59 (64.13%) patients presented in stage IV. 44 patients with adenocarcinoma were subjected to mutational analysis, and an epidermal growth factor receptor mutation was found in 13 (29.5%) patients. None of the patients had ALK mutation, ROS-1 rearrangement, or BRAF mutation. PD-L1 expression was evaluated in 9 patients with NSCLC, and it was found in 6 (66.66%) patients. The overall mean survival was 12.7 months. The mean survival for patients with stages I, II, III, and IV was 70, 96, 8.1, and 12.7 months, respectively. Survival in stage IV was better than in stage III, as the eligible patients received targeted therapy and immunotherapy. Targeted therapy and immunotherapy have improved survival. Molecular analysis should be done whenever indicated, and eligible patients must be administered targeted therapy and immunotherapy.
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424.
DOI: https://doi.org/10.3322/caac.21492
Deshpand R, Chandra M, Rauthan A. Evolving trends in lung cancer: epidemiology, diagnosis, and management. Indian J Cancer 2022;59:S90-105.
DOI: https://doi.org/10.4103/ijc.IJC_52_21
Singh N, Agrawal S, Jiwnani S, et al. Lung cancer in India. J Thorac Oncol 2021;16:1250-66.
DOI: https://doi.org/10.1016/j.jtho.2021.02.004
Groome PA, Bolejack V, Crowley JJ, et al. The IASLC lung cancer staging project: validation of the proposals for revision of the t, n, and m descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol 2007;2:694‑705.
DOI: https://doi.org/10.1097/JTO.0b013e31812d05d5
Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: Proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol 2016;11:39‑51.
Chevallier M, Borgeaud M, Addeo A, Friedlaender A. Oncogenic driver mutations in non-small cell lung cancer: past, present and future. World J Clin Oncol 2021;12:217-37.
DOI: https://doi.org/10.5306/wjco.v12.i4.217
Prasad R, James P, Kesarwani V, et al. Clinicopathological study of bronchogenic carcinoma. Respirology 2004;9:557‑60.
DOI: https://doi.org/10.1111/j.1440-1843.2004.00600.x
Dey A, Biswas D, Saha SK, et al. Comparison study of clinicoradiological profile of primary lung cancer cases: an eastern India experience. Indian J Cancer 2012;49:89‑95.
DOI: https://doi.org/10.4103/0019-509X.98930
Mandal SK, Singh TT, Sharma TD, Amrithalingam V. Clinico‑pathology of lung cancer in a regional cancer center in Northeastern India. Asian Pac J Cancer Prev 2013;14:7277‑81.
DOI: https://doi.org/10.7314/APJCP.2013.14.12.7277
Kaur H, Sehgal IS, Bal A, et al. Evolving epidemiology of lung cancer in India: reducing non‑small cell lung cancer‑not otherwise specified and quantifying tobacco smoke exposure are the key. Indian J Cancer 2017;54:285‑90.
DOI: https://doi.org/10.4103/ijc.IJC_597_16
Gadgeel SM, Ramalingam S, Cummings G, et al. Lung cancer in patients 50 years of age: The experience of an academic multidisciplinary program. Chest 1999;115:1232‑6.
DOI: https://doi.org/10.1378/chest.115.5.1232
Fu JB, Kau TY, Severson RK, Kalemkerian GP. Lung cancer in women: analysis of the national surveillance, epidemiology, and end results database. Chest 2005;127:768‑77.
DOI: https://doi.org/10.1378/chest.127.3.768
Stewart SL, Cardinez CJ, Richardson LC, et al. Surveillance for cancers associated with tobacco use - United States, 1999‑2004. MMWR Surveill Summ 2008;57:1‑33.
Khan NA, Afroz F, Lone MMet al. Profile of lung cancer in Kashmir, India: a five‑year study. Indian J Chest Dis Allied Sci 2006;48:187‑90.
Noronha V, Dikshit R, Raut N, et al. Epidemiology of lung cancer in India: focus on the differences between non‑smokers and smokers: a single‑centre experience. Indian J Cancer 2012;49:74‑81.
DOI: https://doi.org/10.4103/0019-509X.98925
Sharma PK, Bansal R. Profile of lung cancer in predominantly Bidi smoking rural population of northern Himachal Pradesh. Indian J Chest Dis Allied Sci 2013;55:75‑8.
DOI: https://doi.org/10.5005/ijcdas-55-2-75
Baburao A, Narayanswamy H. Clinico‑pathological profile and haematological abnormalities associated with lung cancer in Bangalore, India. Asian Pac J Cancer Prev 2015;16:8235‑8.
DOI: https://doi.org/10.7314/APJCP.2015.16.18.8235
Perng DW, Perng RP, Kuo BI, Chiang SC. The variation of cell type distribution in lung cancer: A study of 10,910 cases at a medical center in Taiwan between 1970 and 1993. Jpn J Clin Oncol 1996;26:229‑33.
DOI: https://doi.org/10.1093/oxfordjournals.jjco.a023219
Minami H, Yoshimura M, Miyamoto Y, et al. Lung cancer in women: sex‑associated differences in survival of patients undergoing resection for lung cancer. Chest 2000;118:1603‑9.
DOI: https://doi.org/10.1378/chest.118.6.1603
Radzikowska E, Głaz P, Roszkowski K. Lung cancer in women: age, smoking, histology, performance status, stage, initial treatment and survival. Population‑based study of 20 561 cases. Ann Oncol 2002;13:1087‑93.
DOI: https://doi.org/10.1093/annonc/mdf187
Gupta RC, Purohit SD, Sharma MP, Bhardwaj S. Primary bronchogenic carcinoma: Clinical profile of 279 cases from mid‑west Rajasthan. Indian J Chest Dis Allied Sci 1998;40:109‑16.
Rawat J, Sindhwani G, Gaur D, et al. Clinico‑pathological profile of lung cancer in Uttarakhand. Lung India 2009;26:74‑6.
DOI: https://doi.org/10.4103/0970-2113.53229
Mohan A, Garg A, Gupta A, et al. Clinical profile of lung cancer in North India: a 10-year analysis of 1862 patients from a tertiary care center. Lung India 2020;37:190-7.
DOI: https://doi.org/10.4103/lungindia.lungindia_333_19
Wakelee HA, Dahlberg SE, Brahmer JR, et al. Differential effect of age on survival in advanced NSCLC in women versus men: analysis of recent Eastern Cooperative Oncology Group (ECOG) studies, with and without bevacizumab. Lung Cancer 2012;76:410‑5.
DOI: https://doi.org/10.1016/j.lungcan.2011.12.006
Schaafsma J, Osoba D. The Karnofsky performance status scale re‑examined: a cross‑validation with the EORTC‑C30. Qual Life Res 1994;3:413‑24.
DOI: https://doi.org/10.1007/BF00435393
Prasad R, Verma SK, Sanjay. Comparison between young and old patients with bronchogenic carcinoma. J Cancer Res Ther 2009;5:31‑5.
DOI: https://doi.org/10.4103/0973-1482.44296
Nations JA, Brown DW, Shao S, et al. Comparative trends in the distribution of lung cancer stage at diagnosis in the department of defense cancer registry and the surveillance, epidemiology, and end results data, 1989–2012. Mil Med 2020;185:e2044-8.
DOI: https://doi.org/10.1093/milmed/usaa218
Morgensztern D, Ng SH, Gao F, Govindan R. Trends in stage distribution for patients with nonsmall cell lung cancer: a national cancer database survey. J Thorac Oncol 2010;5:29-33.
DOI: https://doi.org/10.1097/JTO.0b013e3181c5920c
Fukuoka M, Wu YL, Thongprasert S, et al. Biomarker analyses and final overall survival results from a phase III, randomized, open‑label, first‑line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non‑small‑cell lung cancer in Asia (IPASS). J Clin Oncol 2011;29:2866‑74.
DOI: https://doi.org/10.1200/JCO.2010.33.4235
Sequist LV, Yang JC, Yamamoto N, et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J Clin Oncol 2013;31:3327‑34.
DOI: https://doi.org/10.1200/JCO.2012.44.2806
Shi Y, Au JS, Thongprasert S, et al. A prospective, molecular epidemiology study of EGFR mutations in Asian patients with advanced non‑small‑cell lung cancer of adenocarcinoma histology (PIONEER). J Thorac Oncol 2014;9:154‑62.
DOI: https://doi.org/10.1097/JTO.0000000000000033
Noronha V, Prabhash K, Thavamani A, et al. EGFR mutations in Indian lung cancer patients: Clinical correlation and outcome to EGFR targeted therapy. PLoS One 2013;8:e61561.
DOI: https://doi.org/10.1371/journal.pone.0061561
Doval DC, Azam S, Batra U, et al. Epidermal growth factor receptor mutation in lung adenocarcinoma in India: a single center study. J Carcinog 2013;12:12.
DOI: https://doi.org/10.4103/1477-3163.114970
Kota R, Gundeti S, Gullipalli M, et al. Prevalence and outcome of epidermal growth factor receptor mutations in non‑squamous non‑small cell lung cancer patients. Lung India 2015;32:561‑5.
DOI: https://doi.org/10.4103/0970-2113.168099
Veldore VH, Rao RM, Kakara S, et al. Epidermal growth factor receptor mutation in non‑small‑cell lung carcinomas: a retrospective analysis of 1036 lung cancer specimens from a network of tertiary cancer care centers in India. Indian J Cancer 2013;50:87‑93.
DOI: https://doi.org/10.4103/0019-509X.117013
Pikor LA, Ramnarine VR, Lam S, Lam WL. Genetic alterations defining NSCLC subtypes and their therapeutic implications. Lung Cancer 2013;82:179‑89.
DOI: https://doi.org/10.1016/j.lungcan.2013.07.025
Malik PS, Sharma MC, Mohanti BK, et al. Clinico‑pathological profile of lung cancer at AIIMS: a changing paradigm in India. Asian Pac J Cancer Prev 2013;14:489‑94.
DOI: https://doi.org/10.7314/APJCP.2013.14.1.489
Murali AN, Radhakrishnan V, Ganesan TS, et al. Outcomes in lung cancer: 9‑year experience from a tertiary cancer center in India. J Glob Oncol 2017;3:459‑68.
DOI: https://doi.org/10.1200/JGO.2016.006676
Rajappa S, Gundeti S, Talluri MR, Digumarti R. Chemotherapy for advanced lung cancer: a 5‑year experience. Indian J Cancer 2008;45:20‑6.
DOI: https://doi.org/10.4103/0019-509X.40642
Garg A, Iyer H, Jindal V, et al. Prognostic factors for treatment response and survival outcomes after first-line management of Stage 4 non-small cell lung cancer: a real-world Indian perspective. Lung India 2022;39:102-9.
DOI: https://doi.org/10.4103/lungindia.lungindia_408_21
Ethics Approval
This research was approved by the institutional ethics committee (ESI-PGIMSR IEC/2021008).How to Cite
Kumar, Rahul, Dipti Gothi, Shweta Anand, Shazia Khan, and Nipun Malhotra. 2024. “Survival Among Patients With Lung Cancer Managed at a Tertiary Care Center in North India”. Monaldi Archives for Chest Disease, July. https://doi.org/10.4081/monaldi.2024.3045.
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