PMID- 37057111 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230415 IS - 2218-6751 (Print) IS - 2226-4477 (Electronic) IS - 2218-6751 (Linking) VI - 12 IP - 3 DP - 2023 Mar 31 TI - Real-world data on severe lung cancer: a multicenter retrospective study. PG - 460-470 LID - 10.21037/tlcr-23-4 [doi] AB - BACKGROUND: Severe lung cancer is a novel concept that describes a patient with poor performance status (PS; 2-4) but with a high probability of receiving survival benefit and improvement in the PS score. However, there is currently no relevant research or real-world data on those with severe lung cancer, such as incidence, cause, clinical features, and risk factors. METHODS: The data from patients with advanced lung cancer attending multiple centers from January 1, 2022, to June 30, 2022, were collected for a cross-sectional study. In addition, data from fatal cases from January 1, 2019, to June 30, 2022, were retrospectively collected as another cohort. And we developed a questionnaire to assess clinicians' mastery of severe lung cancer. RESULTS: Three participating institutes enrolled the data set of 1,725 patients, and the dataset of 269 fatal cases were included in another cohort; the incidence of severe lung cancer was 13.10% and 37.55%, respectively. Severe lung cancer patients were mainly stage IV elderly male patients without gene mutation and a history of resection. And the proportion of smoking and comorbidities in severe lung cancer patients is more than in non-severe lung cancer patients (50.4% vs. 40.8%, P=0.006; 46.9% vs. 36.4%, P=0.002). Treatment-related adverse events (AEs) (46.0%) accounted for the largest proportion of the primary causes of severe lung cancer in the cross-sectional study, while cancer-related symptoms (54.5%) accounted for the largest proportion of the primary causes of sever lung cancer in the 101 fatal cases. For the fatal cases, the overall survival of severe lung cancer patients caused by cancer-related symptoms was longer than that caused by treatment-related AEs (8 vs. 3 months; P=0.019). A total of 616 clinicians completed the questionnaire; 90.26% of clinicians agreed with the concept of severe lung cancer. CONCLUSIONS: The incidence of severe lung cancer cannot be ignored based on real-world data. Treatment-related AEs are gradually account for more of the causes of severe lung cancer, surpassing cancer-related symptoms and comorbidities. Furthermore, the prognosis of patients with advanced lung cancer who develop severe lung cancer due to treatment-related AEs is worse than cancer-related symptoms. CI - 2023 Translational Lung Cancer Research. All rights reserved. FAU - Wang, Fei AU - Wang F AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China. FAU - Xie, Xiaohong AU - Xie X AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - Wang, Liqiang AU - Wang L AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - College of Life Science, Henan University, Kaifeng, China. FAU - Deng, Haiyi AU - Deng H AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - Wang, Qian AU - Wang Q AD - Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China. FAU - Qi, Min AU - Qi M AD - Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China. FAU - Guo, Min AU - Guo M AD - Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, Shenzhen, China. FAU - Chen, Juan AU - Chen J AD - Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, Shenzhen, China. FAU - Zhou, Maolin AU - Zhou M AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - Sun, Ni AU - Sun N AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - Li, Ru AU - Li R AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. AD - School of Clinical Medicine, Henan University, Kaifeng, China. FAU - Yang, Yilin AU - Yang Y AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - He, Zuer AU - He Z AD - Department of Clinical Medicine, Nan Shan School of Guangzhou Medical University, Guangzhou, China. FAU - Lin, Xinqing AU - Lin X AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - Liu, Ming AU - Liu M AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. FAU - Wu, Di AU - Wu D AD - Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, Shenzhen, China. FAU - Sun, Gengyun AU - Sun G AD - Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China. FAU - Zhou, Chengzhi AU - Zhou C AD - Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. LA - eng PT - Journal Article DEP - 20230327 PL - China TA - Transl Lung Cancer Res JT - Translational lung cancer research JID - 101646875 PMC - PMC10088003 OTO - NOTNLM OT - Severe lung cancer OT - cross-sectional study OT - prognosis OT - questionnaire OT - real-world data COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-23-4/coif). The authors have no conflicts of interest to declare. EDAT- 2023/04/15 06:00 MHDA- 2023/04/15 06:01 PMCR- 2023/03/31 CRDT- 2023/04/14 02:37 PHST- 2022/11/18 00:00 [received] PHST- 2023/03/21 00:00 [accepted] PHST- 2023/04/15 06:01 [medline] PHST- 2023/04/14 02:37 [entrez] PHST- 2023/04/15 06:00 [pubmed] PHST- 2023/03/31 00:00 [pmc-release] AID - tlcr-12-03-460 [pii] AID - 10.21037/tlcr-23-4 [doi] PST - ppublish SO - Transl Lung Cancer Res. 2023 Mar 31;12(3):460-470. doi: 10.21037/tlcr-23-4. Epub 2023 Mar 27.