OA08.03 The 5-year Survival Rate of Postoperative Non-small Cell Lung Cancer Patients with Two Different Follow-up Patterns

Abstract

Recent studies suggest that different follow-up patterns may influence the survival of cancer patients. This study aimed to compare the 5-year survival rates between the two post-operation follow-up patterns of the patients with stage I-IIIA non-small cell lung cancer (NSCLC). This is a China multicenter, retrospective, observational study. Clinical stage I-IIIA NSCLC (adjusted by AJCC 8th edition) patients who underwent surgical resection and received follow-up within 6 months after initial diagnosis through LinkDoc telephone follow-up system were included from July 2014 to July 2020. Patients who died within 3 months after the surgery were excluded. All enrolled patients are grouped into proactive follow-up (AF) group or passive follow-up (PF) group according to patients’ behavior during follow-up. In the AF group, patients proactively reached out for medical advice at least once aside from routine follow-up. In the PF group, patients underwent routine follow-up (every 3 months for the first 2 years and every 6 months for the following years). The Kaplan-Meier and Cox proportional hazards regression model were used. A total of 11,958 stage I-IIIA NSCLC patients were included from 9 hospitals with a wide geographical representation. No significant difference for the demographic and clinical characteristics were found between the AF group (N=3825) and the PF group (N=8133). In both groups, most patients were male, non-squamous histological type, stage I and the Eastern Cooperative Oncology Group Performance Status (ECOG-PS)≤2. In the AF group and PF group, median call duration were 3.77 and 3.58 minutes; the 5-year survival rate were 81.8% and 74.2% (Figure.1), respectively. Compared with the PF group, the AF group had better 5-year survival rate [hazard ratio (HR)=0.60, 95% confidence interval (CI), 0.53-0.67, P<0.001]. Further, in subgroups of clinical stages, the AF group all presented significantly better 5-year survival rate than the PF group (stage I subgroup, HR=0.59, 95%CI, 0.46-0.75, P <0.001; stage II subgroup, HR=0.64, 95%CI, 0.51-0.79, P <0.001; stage IIIA subgroup, HR=0.54, 95%CI, 0.46-0.64, P <0.001). Multivariate analysis showed that follow-up pattern, age, gender and operation mode were independent prognostic factors of stage I-IIIA NSCLC, and the results were consistent in all subgroups stratified by clinical stages. This real-world study indicated that proactive follow-up through telephone follow-up system leads to better overall survival for resected stage I-IIIA NSCLC patients.