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Clinically diagnosed tumors linked to improvements in cancer-specific survival
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A clinical diagnosis of early-stage lung cancer was associated with improvements in cancer-specific survival compared with only receiving a pathological diagnosis, according to results of a SEER analysis presented at the European Lung Cancer Conference.
Talha Shaikh, MD, radiation oncology resident at Fox Chase Cancer Center, and colleagues sought to examine trends in the use of clinical diagnosis and the effect on treatment outcomes in 7,050 patients receiving radiotherapy for early-stage lung cancer.
Researchers used the SEER database to identify patients aged younger than 18 years diagnosed with stage I disease who underwent radiation therapy between 2004 and 2012.
Overall, 6,399 (90.8%) patients received a diagnosis pathologically and 651 (9.2%) were diagnosed clinically. No significant changes in the use of clinical vs. pathologic diagnosis occurred during the study period.
Results of multivariable analysis indicated no association between clinical diagnosis and improved OS (HR = 1.01; 95% CI, 0.90-1.13). However, clinical diagnosis was associated with improvements in cancer-specific survival (HR = 0.82; 95% CI, 0.71-0.96).
When the researchers stratified patients by clinical T stage, they observed improved cancer-specific survival among clinically diagnosed T1a patients (HR = 0.75; 95% CI 0.58-0.96) and a trend toward improvements in cancer-specific survival in those with clinical T1b tumors (HR = 0.74; 95% CI, 0.55-1).
Patients in the clinical diagnosis group who had tumors sized 1.9 cm or smaller experienced improvements in cancer-specific survival (HR = 0.74; 95% CI, 0.58-0.99). Further, researchers observed a trend toward improvements in cancer-specific survival among those with tumors 2 cm to 2.7 cm in size (HR = 0.78; 95% CI, 0.58-1.03).
When comparing clinically diagnosed vs. pathologically diagnosed tumors, data showed a stepwise increase in the HR for cancer-specific survival according to tumor stage and size.
“The improved cancer-specific survival in clinically diagnosed patients suggests treatment of benign disease, particularly in smaller tumors,” Shaikh and colleagues wrote. “Prudent patient selection is needed to reduce the potential for overtreatment.” – by Jennifer Southall
Reference:
Shaikh T, et al. Abstract 970. Presented at: European Lung Cancer Conference; April 13-16, 2016; Geneva, Switzerland.
Disclosure: The researchers report no relevant financial disclosures.