Ashari, Sofiatulakmal (2022) A retrospective cohort study on overall survival of patients with non small cell lung cancer (NSCLC) and the associated factors with mortality in Hospital Raja Perempuan Zainab II (HRPZ II). Masters thesis, Universiti Sains Malaysia.
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Abstract
Background: The main objective in this study is to determine the 1 year overall survival rate and to describe prognostic factors that affected survival of lung cancer patients in Kelantan population. Methods: This was a retrospective study of Non-Small Cell Lung Cancer (NSCLC) patients carried out from 1st January 2016 until 31st December 2020. Participants were recruited from Respiratory Clinic (RC) Hospital Raja Perempuan Zainab II (HRPZ II). Detailed demographic data, Eastern Cooperative Oncology Group Performance Status (ECOG PS), stage of disease, type of histology, presence of EGFR mutation, distance metastasis, co-morbid, type of treatment and post treatment complications were recorded. The date of histology or cytology confirmation test was used as the date of entry. Survival time was calculated from the date of entry to the date of death. Results: One hundred and eighty participants were included for survival analysis. Non – Small Cell Lung Cancer (NSCLC) patients predominantly male, smokers and aged less 65 years old. Adenocarcinoma 154 (85.6%) is the most common NSCLC subtype as compared to non adenocarcinoma 26 (14.4%). All adenocarcinoma patients were tested for EGFR molecular test and the results showed deletion exon 19 34 (54.0 %) was the most common point mutation compared to other mutation. The overall median survival time was 7.69 months (95% CI: 6.176, 9.200). The probability of survival in 1-year, 2-years and 3-years periods were 28%, 10% and 3%, respectively. Multiple Cox Regression analysis revealed that two significant prognostic factors were sub type EGFR mutation and type of treatment. Exon 19 deletion, exon 20 T790M point mutation and exon 21 L858R mutation were a significant independent prolonged survival with hazard ratio 0.084 (95% CI; 0.021, 0.337; P < 0.000), 0.048 (95% CI; 0.009,0.268; P <0.001) and 0.067 (95% CI; 0.015, 0.287; P< 0.000) respectively. EGFR – TKIs alone and combination therapy (chemotherapy and EGFR – TKIs) were a significant independent prolonged survival with hazard ratio 0.021 (95% CI 0.006, 0.076; P < 0.000) and 0.006 (95% CI 0.001, 0.026; P < 0.000) respectively. Conclusion: The overall median survival time among NSCLC patients in HRPZ II was revealed to be longer than previous study (7.69 months versus 4.5 months). EGFR – TKIs therapy alone and combination therapy (chemotherapy with EGFR – TKIs) were identified as independent good prognostic factors as compared to supportive therapy.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Adenocarcinoma NSCLC, EGFR mutation |
| Subjects: | R Medicine R Medicine > RC Internal medicine |
| Divisions: | Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis |
| Depositing User: | MUHAMMAD AKIF AIMAN AB SHUKOR |
| Date Deposited: | 20 Jul 2026 01:32 |
| Last Modified: | 06 Oct 2026 08:19 |
| URI: | http://eprints.usm.my/id/eprint/64677 |
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