(B-005) Factors Affected the Short-term Mortality in Patients with Non-Small Cell Lung Cancer

Background: Lung cancer is the most common cause of cancer-related deaths worldwide, and there is no clear consensus on the factors contributing survival in NSCLC patients.

Objectives: We conducted a retrospective cohort study to identifying prognostic factors and their impact on survival in NSCLC patients using Taiwan Cancer Registry (TCR) and National Health Insurance Database (NHID)

Methods: Patients who were newly diagnosed with NSCLC stage 3 to stage 4, and then received anticancer drugs treatment were identified from 2012 to 2020 in Taiwan. The date of the initial treatment was defined as the index date. We collected patient characteristics, performance status, comorbidities, and co-medications within one year prior to the index date. Patients were followed up for at least one year. The difference was estimated by standard mean difference (SMD), which >0.1 was considered statistically significant. We grouped patients based on the definition of prognostic factors and conducted the Cox proportional hazard regression analysis.

Results: Total 16,255 NSCLC patients were identified, the average was 65.0-year-old, and 50.2% were female. For the overall patients, sex was a prognostic factor of survival. The risk of death for male was 1.447 (95% CI, = 1.397-1.499) using female as the reference group. The prognostic factors of death for patients included old age, lower BMI ( < 18.5 kg/m2), poor performance status (ECOG score≧1), current smoking, higher weight CCI, receiving medications, such as systemic steroid, antithrombotic agents, and sedatives and hypnotics, tumor histology other than adenocarcinoma, stage 4 NSCLC, did not remove NSCLC by surgery, receiving radiotherapy after initial anti-cancer drugs treatment, lower insurance amount, did not treated at a medical canter, shorter prescription time, and receiving non-platinum-containing chemotherapy.

Conclusions: This study showed that some modifiable prognostic factors, such as BMI, performance status, smoking behavior, and receiving medications, can be adjusted with the assistance of healthcare professionals to improve the treatment outcomes for NSCLC patients. This research provides valuable reference evidence for clinical practice.