479P - The impact of initial symptoms on survival time in advanced non-small cell lung cancer

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Non-Small-Cell Lung Cancer, Metastatic
Aetiology, Epidemiology, Screening and Prevention
Presenter Taichi Miyawaki
Citation Annals of Oncology (2016) 27 (suppl_9): ix139-ix156. 10.1093/annonc/mdw594
Authors T. Miyawaki1, S. Yagishita2, R. Ko3, Y. Suzuki1, N. Matsumoto1, M. Hara1, N. Iwakami1, M. Fujii1, S. Iwakami1, K. Takahashi3
  • 1Department Of Respiratory Medicine, Juntendo University Shizuoka Hospital, 410-2295 - Shizuoka/JP
  • 2Department Of Respiratory Medicine, Juntendo University Urayasu Hospital, 279-0021 - Urayasu/JP
  • 3Department Of Respiratory Medicine, Juntendo University Hospital, 113-8431 - Tokyo/JP



Lung cancer is a leading cause of cancer-related deaths worldwide. One of the reasons for high lung cancer mortality is the delay of diagnosis from initial symptoms, despite the fact that more than half of lung cancer patients seek first medical care in advanced stage. To date, the impact of initial symptoms on survival time has not been widely described in advanced non-small cell lung cancer patients.


Between January 2007 and March 2016, a total of 171 patients were diagnosed as advanced non-small lung cancer (NSCLC) in Juntendo University Shizuoka Hospital. Among them, we retrospectively investigated their patient characteristics, initial symptoms, time from initial symptoms to diagnosis (TISD), and overall survival (OS).


Among 171 patients analyzed, 112 (65%) patients were men and the median age was 69 (39-92) years. Almost 70% of patients had more than 1 of ECOG-Performance Status (PS). Adenocarcinoma histology was most common accounting for 144 (84%) of all patients, of which 40 (23%) patients had EGFR activating mutation. A total of 142 (83%) patients were received 1st line chemotherapy including 108 patients with cytotoxic chemotherapy and 34 patients with EGFR-TKI. There were 119 (70%) symptomatic patients. Major initial symptoms were cough (40, 34%), respiratory distress (24, 20%), pain (22, 18%), and neurological disorder (19, 16%). Median TISD was 1.2 (0-13.3) months and 81 (68%) of patients had more than 1 month of TISD. The median OS of all patients was 12.2 (95% CI: 9.3-16.3) months. Symptomatic patients showed significantly shorter median OS than asymptomatic patients (9.3 vs 16.9 months, p = 0.041, HR 1.46, 95% CI: 1.01-2.10). Although not significant, patients with more than 1 month of TISD (10.4 vs 13.7 months, p = 0.09) and patients with neurological disorder (10.7 vs 12.3 months, p = 0.09) showed shorter median OS than other patients.


Presence of initial symptom is obvious negative prognostic factor in advanced NSCLC. Once again, early diagnosis and early treatment should be emphasized as important factor for the survival improvement in advanced NSCLC.

Clinical trial indentification

Legal entity responsible for the study

Taichi Miyawaki




All authors have declared no conflicts of interest.