Abstract
BackgroundThis study aimed to investigate the incidence and long-term survival outcomes of occult lung cancer between 2004 and 2015.MethodsA total of 2958 patients were diagnosed with occult lung cancer in the 305,054 patients with lung cancer. The entire cohort was used to calculate the crude incidence rate. Eligible 52,472 patients (T1-xN0M0, including 2353 occult lung cancers) were selected from the entire cohort to perform survival analyses after translating T classification according to the 8th TNM staging system. Cancer-specific survival curves for different T classifications were presented.ResultsThe crude incidence rate of occult lung cancer was 1.00 per 100 patients, and it was reduced between 2004 and 2015 [1.4 per 100 persons in 2004; 0.6 per 100 persons in 2015; adjusted risk ratio = 0.437, 95% confidence interval (CI) 0.363–0.527]. In the survival analysis, there were 2206 death events in the 2353 occult lung cancers. The results of the multivariable analysis revealed that the prognoses with occult lung cancer were similar to patients with stage T3N0M0 (adjusted hazard ratio = 1.054, 95% CI 0.986–1.127, p = 0.121). Adjusted survival curves presented the same results. In addition, adjusted for other confounders, female, age ≤ 72 years, surgical treatment, radiotherapy, adenocarcinoma, and non-squamous and non-adenocarcinoma non-small cell carcinoma were independent protective prognostic factors (all p < 0.05).ConclusionsOccult lung cancer was uncommon. However, the cancer-specific survival of occult lung cancer was poor, therefore, we should put the assessment of its prognoses on the agenda. Timely surgical treatment and radiotherapy could improve survival outcomes for those patients. Besides, we still need more research to confirm those findings.
Highlights
This study aimed to investigate the incidence and long-term survival outcomes of occult lung cancer between 2004 and 2015
We found that the classification of Tx was the riskiest factor for the prognoses (Table 4, unadjusted Hazard ratio (HR) =6.339, p < 0.001)
The results revealed that the crude incidence rate of occult lung cancer was 1.00 per 100 patients, and the incidence-rate trend over time was likely to be reduced between 2004 and 2015
Summary
This study aimed to investigate the incidence and long-term survival outcomes of occult lung cancer between 2004 and 2015. For lung cancer patients, the incidence information of occult lung cancer remains insufficient. Patients with stage IA (classification T1N0M0) have the best long-term survival outcomes in all lung cancers [10]. In the guidelines of the National Comprehensive Cancer Network, occult lung cancers are classified as TxN0M0 [12]. The prognosis of occult lung cancer patients remains unclear because of the unclear TNM classification. There was no data about the incidence rate and survival analyses of occult lung cancer in the previous studies. We aimed to investigate the incidence rate and prognostic level of those patients with occult lung cancer
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