Five year survival of non-small cell lung cancer patients in Brunei Darussalam
Chee Fui CHONG 1, Muhamad I ADI 2, Luke MATHEW 3, Muhd Syafiq ABDULLAH 4, Pemasari Upali TELISINGHE 5,
1 Thoracic Unit, Department of Surgery, RIPAS Hospital, 2 Pengiran Anak Puteri Rasidah Sa’adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, 3 Division of Respiratory Medicine, Department of Medicine, RIPAS Hospital, 4 The Brunei Cancer Centre, and 5 Department of Pathology, RIPAS Hospital, Brunei Darussalam.
ABSTRACT
Introduction: Lung cancer has been the leading cause of cancer deaths in Brunei Darussalam for the past five years. This study is the first to supply data for the 5-year survival of patients diagnosed with non-small cell lung cancer (NSCLC) in Brunei Darussalam. Materials and Methods: From 2002 to 2009, 302 patients diagnosed with NSCLC were identified from the National Cancer Registry of Brunei Darussalam. Demographic and clinical data were retrospectively retrieved from the clinical notes. All deaths and dates of death were obtained and crosschecked with the National Birth and Death Registry at the Immigration Department. Data were analysed using SPSS statistical software and 5-year Kaplan-Meier survival curves were derived and analysed. Predictors of 5-year survival were analysed using Cox regression analysis. Results: Mean age of the 302 patients was 64.9 ± 12.8 (27.4–90.6 years) with male to female ratio of 194:108. Racial distribution consisted of 84.4% (n=255) Malay, 12.5% (n=38) Chinese and 3.1% of other racial origin (indigenous and foreign nationals). Histological types of NSCLC consisted of 67.9% (n=205) adenocarcinoma, 16.2% (n=49) squamous cell carcinoma, 6.3% (n=19) large cell carcinoma, 5.3% (n=16) bronchioalveolar carcinoma and 4.3% of other origin. Only 13.9% of patients underwent surgical resection. At completion of follow-up, only 47 (15.5%) patients were still alive. There were 255 deaths. Overall 5-year survival for the whole group was 3.6% with a median survival time of 6.5 ± 0.9 months (95% CI: 4.7-8.4 months) but according to stage of disease was 60.9% for Stage IA, 29.9% for Stage IB, 10.0% for Stage IIB, 7% for Stage IIIB and 3% for Stage IV. Significant prognostic factors were younger age at diagnosis, surgical resection, tumour types and tumour stages. Conclusion: Overall 5-year survival of patients diagnosed with NSCLC in Brunei Darussalam is still generally poor but comparable to previously reported data. Significant prognostic factors were younger age at diagnosis, surgical resection, tumour types and tumour stages.
Keywords: Carcinoma, non-small-cell lung cancer, survival analysis, thoracic surgery, cancer staging
Correspondence author: Chee Fui CHONG, Thoracic Unit, Department of Surgery, RIPAS Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam. Tel: +673 2242424 280 E mail: wcfchong@gmail.com
Brunei Int Med J. 2013; 9 (1): 12-21