Real-world data on severe lung cancer: a multicenter retrospective study

Area of Science:

• Oncology
• Clinical Medicine
• Public Health

Background:

• Severe lung cancer is a novel concept for patients with poor performance status (PS) but potential for survival benefit.
• Limited real-world data exists on the incidence, causes, and risk factors of severe lung cancer.

Purpose of the Study:

• To investigate the incidence, causes, clinical features, and risk factors of severe lung cancer.
• To assess clinicians' understanding and acceptance of the severe lung cancer concept.

Main Methods:

• A cross-sectional study of 1,725 advanced lung cancer patients (Jan-Jun 2022).
• A retrospective cohort of 269 fatal lung cancer cases (Jan 2019-Jun 2022).
• A questionnaire survey of 616 clinicians assessing the severe lung cancer concept.

Main Results:

• Incidence of severe lung cancer was 13.10% (cross-sectional) and 37.55% (fatal cases).
• Severe cases were often elderly males, stage IV, with no gene mutation or resection history, higher smoking rates, and more comorbidities.
• Treatment-related adverse events (AEs) were the primary cause in 46.0% of severe cases (cross-sectional), while cancer symptoms predominated in fatal cases (54.5%).
• Prognosis was worse for severe lung cancer caused by AEs (3 months) vs. symptoms (8 months).
• 90.26% of clinicians agreed with the severe lung cancer concept.

Conclusions:

• The incidence of severe lung cancer is significant and warrants attention.
• Treatment-related AEs are an increasing cause of severe lung cancer, surpassing cancer symptoms and comorbidities.
• Severe lung cancer resulting from AEs has a poorer prognosis compared to that caused by cancer symptoms.