Survival outcome of non-small cell lung cancer (NSCLC) patients: Comparing results between the database of the Comprehensive Cancer Center Zürich (CCCZ) and the Epidemiological Cancer Registry Zurich and Zug (KKR)

Date

28 Sep 2019

Session

Poster Display session 1

Presenters

Rolf A. Stahel

Citation

Annals of Oncology (2019) 30 (suppl_5): v591-v601. 10.1093/annonc/mdz259

Authors

R.A. Stahel1, A. Curioni2, S. Rohrmann3, U. Dafni4, U. Sandner5, N. Andratschke6, G. Dimopoulou4, M. Guckenberger7, M. Kohler8, K. Matthes3, I. Opitz9, W. Weder9

Author affiliations

  • 1 Comprehensive Cancer Center Zürich, University Hospital Zürich, 8091 - Zurich/CH
  • 2 Center Of Hematology And Oncology, University Hospital Zürich, 8091 - Zurich/CH
  • 3 Institut Für Pathologie & Molekularpath., University Hospital Zürich, 8091 - Zurich/CH
  • 4 Public Health, University of Athens, 115 27 - Athens/GR
  • 5 Comprehensive Cancer Center Zurich, University Hospital Zurich, 8091 - Zürich/CH
  • 6 Department Of Radiation Oncology, Universitätsspital Zürich, 8091 - Zürich/CH
  • 7 Department For Radiation Oncology, University Hospital Zürich, 8091 - Zurich/CH
  • 8 Department Of Pneumonology, University Hospital Zurich, 8091 - Zurich/CH
  • 9 Thoracic Surgery Department, University Hospital Zürich, 8091 - Zurich/CH
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Resources

Background

The Thoracic Oncology Centre of the University Hospital Zürich, founded in 2011, is certified by the German Cancer Society, and is one of 17 multidisciplinary organ-based centres of the CCCZ. All treatment recommendations are made at a multidisciplinary tumor board. Since 1980, all new cancer cases among the population of both cantons Zurich and Zug, are registered in the KKR.

Methods

The aim of the current study is to quantify the mortality risk of patients with NSCLC and identify differences on survival time and other factors between patients receiving their primary treatment at the CCCZ and those treated elsewhere and registered by KKR. Association of sex, histology, stage and age at initial diagnosis to survival as well as differential effect on survival between CCCZ and KKR are also explored. Imputation of last follow-up date of KKR by the database cut-off date (7 August 2018) was used, to address possible underestimation of survival due to missingness in this centre.

Results

Patients included 848 primary cases from the CCCZ and 1761 cases from the KKR diagnosed between January 1, 2011 and December 31, 2015. A comparable median follow-up time of 57 months and 56 months for CCCZ and KKR patients, respectively, was calculated. OS is significantly superior for CCCZ patients as compared to KKR patients (median: 36.0m, 95%CI:[31.0, 45.0] versus 12.0m, 95%CI:[11.0, 13.0];HR=1.71 [95% CI 1.54, 1.90] p < 0.001). This difference remained significant when examined in the subgroups of gender, age (≤65 and >65y), UICC stage (I/II, III, IV), and histology (squamous, adenocarcinoma). The effect of treatment outside or within the CCCZ on patients’ survival remained significant (HR = 1.42 [95% CI 1.27, 1.57]; p < 0.001) in multivariate analysis adjusting for sex, histology, UICC stage and age at diagnosis, all factors with a significant effect on OS.

Conclusions

Our analysis provides further evidence of the importance of the volume of experience and the availability of a multidisciplinary organisation and research environment, as delivered by a comprehensive cancer centre, on the outcome of patients with all stages of NSCLC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Comprehensive Cancer Center Zürich.

Funding

Has not received any funding.

Disclosure

R.A. Stahel: Advisory / Consultancy: I have received honoraria as a consultant at advisory boards from AbbVie, AstraZeneca, Boehringer Ingelheim, MSD, Pfizer, Roche and Takeda.; Speaker Bureau / Expert testimony: I have received honoraria as a speaker from AstraZeneca, Boehringer Ingelheim, MSD and Roche.; Honoraria (self): Roche and Takeda; Research grant / Funding (institution), ETOP trials (president and scientific chair): AstraZeneca, BMS, Boehringer Ingelheim, Genentech, MSD, Roche, and Pfizer. All other authors have declared no conflicts of interest.

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