Download Christie Clinical Outcomes Non-small cell lung cancer

Christie Clinical Outcomes
Non-small cell lung cancer (NSCLC)
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Christie Patients
Over 1000 patients are referred to the Christie each
year with non-small cell lung cancer. The average
age of NSCLC patients at the Christie is 70 years
and there are slightly more male than female
patients each year (Fig. 1).
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Map 1. Catchment area for 95% ¹ of Christie
patients. Depth of colour is relative to density
of patients
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Fig. 1. Number of new patients per year
Diagnosis
Disease stage is a way of describing the size
and spread of cancer. Stage I is a small
cancer which hasn’t spread, stage IV is an
advanced or metastatic cancer. Fig. 3
shows that almost half of the NSCLC
patients that come to the Christie for
treatment have stage IV disease.
Nationally, 36% of patients are diagnosed
with stage IV disease.
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Comorbidities
Comorbidities are illnesses and conditions that
patients have (other than cancer) such as heart
disease and respiratory problems that can impact
on their treatment and likely outcomes. All Christie
patients are regularly assessed for comorbidities on
a scale of no comorbidities to severe comorbidities.
Two-thirds of Christie NSCLC patients have either
no or only mild comorbidities (Fig. 2). The most
common comorbidity among NSCLC patients is
cardiovascular disease.
The majority of Christie patients are
residents of the North West of England and
in particular around the Greater
Manchester region (Map 1). A very small
number of patients travel from outside the
NW for treatment.
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Stage I
Stage II
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Stage IV
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Fig. 2. Comorbidities
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Fig. 3 Disease stage
small number of patients are distributed outside of the shading, these have been excluded for data protection purposes
Christie Treatment
The type of treatment a patient will receive at the Christie will depend upon many factors which the
clinician will discuss with the patient. The discussion will include the stage of disease at
presentation (Fig 4), other health problems that the patient has at the time of treatment
(comorbidities) and the patient’s ability to cope with the potential effects of the treatment.
Stage II
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Stage IV
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Stage I
curative
Almost 40% of Christie NSCLC
patients are referred for curative
treatment. Of those receiving
treatment with curative intent, 13%
are referred for chemotherapy or
radiotherapy following surgery at
another hospital. The remainder
patients receive chemotherapy or
radiotherapy as their first
treatment.
palliative
Fig. 4 Treatment intent for NSCLC patients
diagnosed with different stages of cancer
Survival Outcomes
Survival outcomes are also highly
dependent on stage of disease (Fig. 5)
and the patient’s general health and
fitness (also known as performance
status) (Fig. 6) .) All Christie patients
are assessed for performance status
using a scale of 0 (patient is fully active)
to 4 (completely disabled by poor
health) developed by the Eastern
Cooperative Oncology group (ECOG).
The majority of Christie NSCLC patients
have a performance status of at least 3
(capable of limited self care). One year
survival for all NSCLC patients treated at
the Christie is 41%. This is higher than
overall one year survival published for
England. This can be at least partly
explained by the fact that patients
resident in the NW with advanced stage
disease and who are too unwell for
treatment are not referred to the
Christie.
Fig. 5 Survival estimates for NSCLC patients
diagnosed with different stages of cancer
Fig. 6 Survival estimates for NSCLC patients with
different levels of fitness (ECOG performance status) at
diagnosis
For more information please contact the Clinical Outcomes Unit at [email protected]