Survival in Untreated Early Stage Non-small Cell Lung Cancer

Background: The aim of this study was to determine the survival of untreated stage I and II in non- small cell lung cancer (NSCLC) patients. Patients and Methods: A retrospective analysis of medical charts of all patients diagnosed with early stage NSCLC, between January 1990 and December 2001, was conducted and patients who were not treated were identified. Data on patient's age, gender, stage of the disease, pathology, reason for non- treatment and cause of death were reviewed. Results: Thirty- nine patients with untreated stage I and II NSCLC were identified. The median age at diagnosis was 77 years; 66.7% were men and 33.3% were women. All patients were Caucasian and 66.7% had stage I disease, 46.2% had squamous cell carcinoma, while adenocarcinoma was found in 28.2%. The major reason for non treatment was chronic obstructive pulmonary disease (64.1%) and the main cause of death was metastatic disease (48.7%). The overall mean survival was 11.9 months. The mean survival at stage I was not statistically different from the mean survival at stage II (13.7 months vs. 8.4 months) (p<0.12). Conclusion: Patients with untreated early stages NSCLC have a very poor prognosis. Alternative therapies that are better tolerated should be investigated in these patients with early stage NSCLC who cannot be offered standard treatment. Lung cancer is the most frequent cause of cancer death in both men and women in the world. In 1999, worldwide, there were 1.04 million (12.8%) new cases and 921,000 deaths (17.8%) due to lung cancer (1). In the United States alone, the American Cancer Society estimates that there will be 172,570 new cases of lung cancer and 163,510 deaths will occur from lung cancer during 2005 (2). The 5-year survival of early stage lung cancer has been reported to be between 45 to 70% (3-9). In contrast, the management of patients with early stage lung cancer who are medically inoperable is controversial. Involved-field radiotherapy is generally considered the treatment of choice for those patients who could not undergo surgery (10). The clinical course of the disease in patients with early stage NSCLC, who are not candidates for surgery or radiation therapy, is not well defined due to a relative lack of data and, as a result, the optimal treatment of these patients is unclear. Hence, we conducted this study in patients with stages I and II NSCLC, who could not be treated with either of the current standard therapeutic interventions, in order to better define the clinical course of untreated early stage NSCLC.