Pneumologie 2019; 73(S 01)
DOI: 10.1055/s-0039-1678204
Posterbegehung (P16) – Sektion Pneumologische Onkologie
NSCLC frühe Stadien, besondere klinische Situationen
Georg Thieme Verlag KG Stuttgart · New York

Early Mortality in Patients with Lung Cancer: Risk Factors for Death within 30 Days or 60 Days of Initial Diagnosis

A Tufman
1   Department of Internal Medicine V, Respiratory Medicine and Thoracic Oncology, Thoracic Oncology Centre Munich, Ludwig-Maximilians-Universität München, Member of the German Center for Lung Research (Dzl Cpc-M)
,
S Schneiderbauer
2   Comprehensive Cancer Center Munich
,
D Kauffmann-Guerrero
1   Department of Internal Medicine V, Respiratory Medicine and Thoracic Oncology, Thoracic Oncology Centre Munich, Ludwig-Maximilians-Universität München, Member of the German Center for Lung Research (Dzl Cpc-M)
,
F Manapov
3   Department of Radiation Oncology, Thoracic Oncology Centre Munich, Ludwig-Maximilians-Universität München, Member of the German Center for Lung Research (Dzl Cpc-M)
,
C Schneider
4   Department of Thoracic Surgery, Thoracic Oncology Centre Munich, Ludwig-Maximilians-Universität München, Member of the German Center for Lung Research (Dzl Cpc-M)
,
Z Syunyaeva
1   Department of Internal Medicine V, Respiratory Medicine and Thoracic Oncology, Thoracic Oncology Centre Munich, Ludwig-Maximilians-Universität München, Member of the German Center for Lung Research (Dzl Cpc-M)
,
K Kahnert
1   Department of Internal Medicine V, Respiratory Medicine and Thoracic Oncology, Thoracic Oncology Centre Munich, Ludwig-Maximilians-Universität München, Member of the German Center for Lung Research (Dzl Cpc-M)
,
J Behr
1   Department of Internal Medicine V, Respiratory Medicine and Thoracic Oncology, Thoracic Oncology Centre Munich, Ludwig-Maximilians-Universität München, Member of the German Center for Lung Research (Dzl Cpc-M)
,
D Nasseh
2   Comprehensive Cancer Center Munich
› Author Affiliations
Further Information

Publication History

Publication Date:
19 February 2019 (online)

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Background Long term survival has improved for some patients with lung cancer; however, very early mortality occurs in a subset of patients. We aim to better understand the factors associated with early mortality in the context of current individualised lung cancer treatment.

Methods Patient records from 2013 to 2017 from the University Hospital LMU Munich were reviewed. Lung cancer patients were divided into three subgroups based on overall survival: early death within 30 d (group 1), death within 60 d (group 2) or no early death (survival > 60 d; group 3). Patients lost to follow up within 60 d were excluded. Factors associated with early and very early death were analysed in a descriptive manner.

Results 1965 patients with lung cancer were identified in the local tumour documentation system. Mortality data was available for 540 (27%) patients, and 1761 (89,6%) patients could be assigned to one of the three groups (204 patients excluded). There were 43 patients in group 1 and 30 in group 2. Mean age: group 1 71,6 y, group 2 70,1 y vs. 65,9 y in group 3.

SCLC was more common in group 1 (14,0% vs. 10,0% and 10,8% in group 2 & 3). Advanced stage at diagnosis and poor ECOG PS were more frequent in group 1 (UICC 3/4 in group 1, 2, 3: 94,3%, 89,7%, 73,7%; ECOG 3/4 in group 1,2,3: 14,0%, 3,3%, 2,2%).

Group 1 & 2 received less treatment than group 3, but those treated in group 1 were treated immediately, with a median time to treatment of 1 d vs. 14 d in group 2 and 19 d in group 3.

Discussion In this retrospective descriptive analysis very early lung cancer mortality (< 30 d from first diagnosis) was associated with older age at first diagnosis, as well as poor ECOG performance status, advanced stage at diagnosis and SCLC histology. Many patients with very early mortality did not receive active anti-cancer treatment, possibly due to poor performance status, patient preference or rapid clinical deterioration. Optimised data sets and multifactorial analyses are required to more precisely examine the causes of very early death in lung cancer.