Retrospective cohort study of unresectable stage III non-small-cell lung cancer in Canada

  • S.J. Seung HOPE Research Centre, Sunnybrook Research Institute
  • M. Hurry AstraZeneca Canada Inc
  • R. N. Walton AstraZeneca Canada Inc
  • W.K. Evans McMaster University
Keywords: Lung cancer, unresectable stage iii disease, real-world evidence


Background The management of unresectable stage iii non-small-cell lung cancer (nsclc) is complex and best determined through multidisciplinary consultation. A longitudinal, population-level study was carried out to describe the management approach and outcomes of treatment in the real-world setting in Ontario.

Methods Individuals diagnosed with nsclc between 1 April 2010 and 31 March 2015 were identified in the Ontario Cancer Registry. Unresectable disease was defined as no surgery reported within 3 months of diagnosis. Initial treatments included radiotherapy (rt, curative or palliative), chemotherapy, targeted therapy, and chemoradiation [crt, concurrent (ccrt) or sequential (scrt)]. Survival was calculated from diagnosis with stage iii disease to death or last follow-up.

Results Of the 24,729 individuals diagnosed with nsclc, 5243 (21.2%) had stage iii disease, with most of the latter group (4542, 86.6%) having unresectable disease. Median age was 70 years, and 54.2% were men. The frequency of first-line treatment was ccrt, 22.1%; palliative rt, 21.0%; curative rt, 19.6%; no treatment, 19.6%; chemotherapy alone, 11.6%; scrt, 5.4%; and targeted therapy, 0.7%. Median overall survival (mos) was 14.2 months [95% confidence interval (ci): 13.6 months to 14.7 months], with the longest survival observed in patients who received targeted therapy (mos: 34.7 months; 95% ci: 21.4 months to 51.2 months), and the poorest, in those receiving no cancer treatment (mos: 5.9 months; 95% ci: 5.0 months to 6.4 months). The mos in patients receiving ccrt was 23.6 months (95% ci: 21.4 months to 25.6 months).

Conclusions Guideline-recommended ccrt is undertaken in only a small proportion of patients with unresectable nsclc in Ontario. The reasons for low uptake of that recommendation are only partly understood.

Author Biography

W.K. Evans, McMaster University

Department of Oncology, Division of Medical Oncology

How to Cite
Seung, S., Hurry, M., Walton, R. N., & Evans, W. (2020). Retrospective cohort study of unresectable stage III non-small-cell lung cancer in Canada. Current Oncology, 27(4).
Translational Research