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Clinical Features of 5,628 Primary Lung Cancer Patients^*

Experience at Mayo Clinic From 1997 to 2003

^* From the Divisions of Epidemiology (Dr. Yang), General Thoracic Surgery (Drs. Allen and Deschamps), Anatomic Pathology (Dr. Aubry), Biostatistics (Mr. Wampfler), Medical Oncology (Drs. Marks, Adjei, and Jett), Pulmonary Medicine (Dr. Edell), and Experimental Pathology (Dr. Thibodeau), Mayo Clinic College of Medicine, Rochester, MN.

Correspondence to: Ping Yang, MD, PhD, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905; e-mail: yang.ping{at}mayo.edu

Study objectives: To improve the current understanding of the etiology and natural history of primary lung cancer, we need to study the dynamic changes of clinical presentation and prognosis among a large number of patients with newly diagnosed lung cancer. In this report, we present the clinical features and survival rates up to 5 years of a patient cohort.

Design: We identified 5,628 primary lung cancer patients between 1997 and 2002 and followed them through 2003 using multiple, complementary resources.

Measurements and results: Of the 5,628 patients, 58% were men with a mean age at lung cancer diagnosis of 66 years, and 42% were women with a mean age at diagnosis of 64 years. Ten percent were < 50 years, and 8% were > 80 years at diagnosis. A tobacco smoking history was present in 89% of patients, and 40% were smoking at the time of diagnosis. The estimated overall 5-year survival rates of patients with non-small cell lung cancer (NSCLC) by disease stage was as follows: IA, 66%; IB, 53%; IIA, 42%; IIB, 36%; IIIA, 10%; IIIB, 12%; and IV, 4%. The 5-year survival rate of patients with small cell lung cancer was 22% for limited disease and 1% for extensive disease. Approximately 50% of all patients are participants in one or more research studies, and nearly 75% of these patients have donated biological specimens for research.

Conclusion: The survival rate of this cohort of lung cancer patients was slightly improved compared with earlier reports, particularly for patients with low-stage NSCLC. Our patient and biospecimen resource has enabled us to obtain timely results from clinical and translational research of lung cancer.

Key Words: histology • lung cancer • overall survival • referral bias • TNM staging

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