Clinicopathological characteristics and prognosis of non-small cell lung cancer in Algeria: a single-center retrospective study.

ABSTRACT

BACKGROUND: Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer-related death in men in Algeria. Little is known about the characteristics of lung cancer in Algeria. This study aimed to determine the clinicopathological characteristics and prognosis of non-small cell lung cancer (NSCLC) patients in Algeria. METHODS: This retrospective study was performed on 269 pathologically confirmed cases of NSCLC at the Benbadis University Hospital of Constantine (2015-2023). Of these, 95 patients were included in the survival analysis. The clinicopathological and outcome data were investigated based on the patients' medical records. RESULTS: This study showed male predominance with sex ratio of 5.7, with a mean age of 61.8 years. Histologically, 67.3% of cases had adenocarcinoma (ADC) and 22.7% squamous cell carcinoma (SCC). ADC and SCC occurred more frequently in female (p = 0.02) and male (p = 0.003) patients, respectively. Smoking was estimated at 82.2% in men. Over 28% were non-smokers, of which 50.7% were women, and presented at younger age (p = 0.04). Most of our patients (75.5%) have an advanced stage at diagnosis. Around 70% of patients underwent chemotherapy (CT) as first-line treatment, with medians diagnostic and treatment delays of 4 and 1 months, respectively. The median overall survival (mOS) was estimated at 10.3 and 6.7 months in I-III and IV stages, respectively. Other factors that negatively impact OS were age > 65 years (p = 0.01), and the presence of symptoms (p = 0.005) and comorbidity (p = 0.004) in stage IV, and delayed treatment (p = 0.03) and receiving CT alone (p = 0.03) in stages I-III cases. Medians progression free survival (mPFS) in stage IV, III, and II patients were 4.1, 5.2, and 8.3 months, respectively, and negatively affected by the comorbidity (stage IV, p = 0.03) and receiving CT alone (stages II-III, p = 0.03). CONCLUSIONS: NSCLC presents at an early age and advanced stage in Algerian patients. ADC is the most frequent histological subtype and smoking remains the most important risk factor in men. Furthermore, the prognostic factors affecting survival are stage, age, comorbidity, symptoms, and treatment. Thus, tobacco control, early detection program, and access to novel therapies may be the best strategies to reduce NSCLC morbidity and mortality.