PHILADELPHIA (April 6, 2016) — Improved cancer-specific survival rates for clinically diagnosed versus pathologically diagnosed patients with presumed early-stage lung cancer suggested possible overtreatment of benign disease — especially in the case of smaller tumors, according to researchers from Fox Chase Cancer Center–Temple Health.
Study investigator Talha Shaikh, MD, a Radiation Oncology resident at Fox Chase, will present the findings during the Multidisciplinary Management of Thoracic Malignancies session at the European Lung Cancer Conference (ELCC) in Geneva, Switzerland on April 13-16, 2016.
“The main finding of our study is the improved cancer-specific survival in patients undergoing clinical versus pathologic diagnosis for Stage I lung cancer without any difference in overall survival,” Shaikh said. “We hypothesize that the disparity in cancer-specific survival between patients diagnosed clinically versus pathologically may be due to a greater number of patients in the clinical diagnosis arm having benign disease, which precludes them from developing a cancer related death.”
The research team reviewed information from the Surveillance, Epidemiology and End Results (SEER) registry over an eight year period beginning in 2004. They sought to evaluate trends in the method of diagnosis of early-stage lung cancer and to determine the association between method of diagnosis and outcome of treatment. Their analysis included data from 7,050 patients 18 years and older who received only radiation therapy for clinical stage I (T1a-T2aN0) non-small cell lung cancer.
Far fewer patients received a clinical diagnosis of early-stage lung cancer than a pathological diagnosis — 9.2 percent compared to 90.8, respectively — but the researchers found no statistically significant change in the method of diagnosis over the course of the study.
In some patient subgroups, patients with clinically diagnosed disease showed improved cancer- specific survival rates that were significant. Improved rates of cancer-specific survival but not overall survival were linked to clinical diagnosis. Clinically diagnosed early-stage lung cancer did not associate with overall survival.
“We advise taking a more prudent approach in patient selection to reduce overtreatment of potential benign disease, particularly in patients with smaller tumors,” Shaikh said.