医学
阶段(地层学)
无症状的
内科学
肺癌
肺癌筛查
癌
癌症
肿瘤科
胃肠病学
生物
古生物学
作者
John Austin,Rowena Yip,Belinda D’Souza,David F. Yankelevitz,Claudia I. Henschke
出处
期刊:Lung Cancer
[Elsevier]
日期:2012-06-01
卷期号:76 (3): 339-343
被引量:26
标识
DOI:10.1016/j.lungcan.2011.11.017
摘要
Background Prognosis is incompletely known for small-cell lung carcinoma (SCLC) detected by CT screening of at-risk subjects. Methods A multinational study of baseline and annual repeat CT screening for lung cancer of 48,037 at-risk subjects yielded 48 persons (median age 68 years) with SCLC. Stage (tumor, node, metastasis system) distribution and death rates were compared with those of 7960 usual-care SCLC subjects (chi-square or Fisher exact testing, as appropriate), as reported by the International Association for the Study of Lung Cancer. Cure was estimated by Kaplan–Meier analysis. Results Forty-four (92%) of the patients were asymptomatic at screening CT detection of their SCLC; four (8%) presented with cancer-related symptoms before the next scheduled repeat screening. SCLC was diagnosed in clinical stages IA and IV in 16 (33%) and 7 (15%), respectively, of 48 patients, compared to 211 (3%) and 4530 (57%), respectively, of the 7960 patients in the usual-care study (P < 0.0001). Tumor diameter was ≤3.0 cm for each of the 16 subjects in clinical stage I. The percentage of clinical stage I SCLC-related deaths within 5 years was lower in the screening study than in the usual-care study (44% vs. 71%, P = 0.03), as was also the percentage of advanced stage (IIIB plus IV) SCLC-related deaths (62% vs. 94%, P < 0.0001). Conclusions Compared to usual-care detection of SCLC, CT screening identified a shift toward early stage and away from late stage disease, and was associated with a decrease in deaths from the disease.
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