Longs survivants de cancers bronchiques non à petites cellules stades IIIB-IV. Caractéristiques et facteurs pronostiques à partir d’une série rétrospective

Introduction The prognosis of non-small cell lung cancer (NSCLC) is poor, especially for advanced stages IIIB-IV. Clinical experience shows that the evolution of the disease is heterogeneous. A small number of patients survive more than 2 years after diagnosis; they are called long term survivors (LS). The aim of our study was to characterise this subgroup of patients. Methods A retrospective study in the respiratory department of a general hospital including all patients with a proven diagnosis of NSCLC stage IIIB and IV. Results 169 patients were included (43 females). There were 13.6% LS. Two thirds of the patients were PS 0-1, 84.6% were stage IIIBw-IV. Adenocarcinoma was the predominant histological type. Univariate analysis revealed that long term survival was associated with a Charlson's score <= 2, PS 0-1, a normal white blood cell count at diagnosis, adenocarcinoma histology, response (RP) to first line treatment and treatment with a tyrosine-kinase inhibitor (TKI). In multivariate analysis only PS 0-1, RP and treatment with a TKI were independent factors for longer survival. Conclusion LS exist and represent 13.6% of our patients. TKI appear to offer new opportunities for these patients.