Outcomes of Treatment, Survival Rates, and Factors related to Survival of Stage III Lung Cancer Patients Treated at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.

Abstract

Lung cancer (LC) is the leading cause of death worldwide. Stage III lung cancer (Stage III-LC) is characterized by local metastasis. The treatments for LC differ at each stage, while for stage IIIA and IIIB treatment various approaches have been tried with uncertain results. We determined the survival time of Stage III-LC patient and compared survival among multiple factors. Data were collected from the Srinagarind Hospital-Based Cancer Registry (2014 - 2019). 324 patients from Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand, were followed up until December 31, 2021. The survival rate was estimated using Kaplan-Meier and the Log-rank test. In addition, hazard ratios (HR) and the 95% CI were estimated using Cox regression. Of the 324 Stage III-LC patients, the total follow-up time was 447.3 person-years, and 288 cases died during the study, for a mortality rate of 64.4 per 100 person-years (95% CI: 57.40-72.27). The respective 1-, 3-, and 5-year survival rate was 44.1% (95% CI: 38.67-49.45), 16.2 (95% CI: 12.34-20.51), and 9.3 (95% CI: 6.14-13.31). The median survival time was 0.84 years (10.1 months) (95% CI: 0.73-1.00). After adjusting for sex and stage of disease, sequential chemoradiotherapy (SC) represented the most independent predictor of the risk of death (adjusted HR= 1.58; 95% CI: 1.41-2.18). Females had a mortality risk of 0.74-fold compared to males (adjusted HR = 0.74, 95% CI: 0.57-0.95). Stage of disease and stages IIIB and III (unknown and undefined) had a respective 1.33-fold (adjusted HR = 1.33, 95% CI: 1.00-1.84) and 1.48-fold (adjusted HR = 1.48, 95% CI: 1.09-2.00) risk of death compared to stage IIIA. Sex, stage of disease, and SC were related to stage III-LC survival, so physicians should emphasize combination therapy. Further research should focus on combination therapy and survival among Stage III-LC patients.