Despite recent improvements in early-stage non-small-cell lung cancer (NSCLC), disease relapse remains challenging. Moreover, real-world evidence on long-term follow-up of disease-free survival (DFS) and recurrence patterns in a large, unselected cohort of early-stage NSCLC patients is lacking. This cohort study aimed to assess clinical characteristics, diagnostic workup, treatment, survival, and risk of disease relapse among early-stage NSCLC patients. Adult patients with stage IB, II, or IIIA NSCLC diagnosed and/or treated at Aarhus University Hospital in Denmark from January 2010 to December 2020 were included and followed-up until May 2021. Comprehensive clinical data were collected from electronic medical records of eligible patients and linked to Danish register data. The study population comprised 1341 early-stage NSCLC patients: 22%, 40%, and 38% were diagnosed with stage IB, II, and IIIA disease, respectively. In total, 42% of patients were tested for epidermal growth factor receptor (EGFR), of whom 10% were EGFR-mutation-positive (EGFRm+). Half of all patients received surgery, and nine percent of patients received stereotactic body radiation therapy (SBRT). Disease-free survival 5 years post-diagnosis was 49%, 42%, and 22% for stage IB, II, and stage IIIA patients, respectively. DFS improved over time both for patients treated with surgery and SBRT. However, disease relapse remained a challenge, with approximately 40% of stage IIIA having relapsed 3 years post-diagnosis. This study contributes important knowledge that puts clinical trials on new perioperative treatment modalities for early-stage NSCLC patients into perspective. Our findings cover an essential evidence gap on real-world DFS and recurrence dynamics, confirming that despite an improvement in DFS over time and across different treatment modalities, disease relapse remains a monumental challenge. Therefore, better treatment strategies are needed.
尽管早期非小细胞肺癌（NSCLC）的治疗近期有所改善，疾病复发仍是严峻挑战。此外，目前尚缺乏针对大规模、未经筛选的早期NSCLC患者群体无病生存期（DFS）长期随访及复发模式的真实世界证据。本队列研究旨在评估早期NSCLC患者的临床特征、诊断流程、治疗方案、生存状况及疾病复发风险。研究纳入2010年1月至2020年12月在丹麦奥胡斯大学医院确诊和/或治疗的IB期、II期或IIIA期NSCLC成年患者，随访至2021年5月。从符合条件患者的电子病历中收集完整临床数据，并与丹麦登记数据关联。研究人群共包括1341例早期NSCLC患者：分别有22%、40%和38%确诊为IB期、II期和IIIA期疾病。总体而言，42%的患者接受了表皮生长因子受体（EGFR）检测，其中10%为EGFR突变阳性（EGFRm+）。半数患者接受手术治疗，9%的患者接受立体定向放射治疗（SBRT）。IB期、II期和IIIA期患者确诊后5年无病生存率分别为49%、42%和22%。接受手术和SBRT治疗患者的DFS均随时间推移有所改善。然而疾病复发仍是重大挑战，约40%的IIIA期患者在确诊后3年内出现复发。本研究为早期NSCLC患者新型围手术期治疗方案的临床试验提供了重要参考依据。我们的发现填补了真实世界DFS与复发动态研究的关键证据空白，证实尽管不同治疗方式的DFS随时间推移有所改善，疾病复发仍是亟待解决的重大难题，因此需要制定更优的治疗策略。
肿瘤(癌症)患者之家