A real-world analysis of nonmetastatic non-small-cell lung cancer in Italy

e20566 Background: The majority of all lung cancer cases are represented by non-small cell lung cancer (NSCLC), for which the standard of care is surgical resection. Chemotherapy, radiotherapy and immunotherapy are the most important perioperative systemic treatments. This study aimed to identify newly NSCLC diagnosed, non-metastatic (i.e., stages I-III) and resected patients, and characterize them from the perspective of the Italian National Health Service (INHS). Methods: From the Fondazione ReS (Ricerca e Salute) database (~5 million inhabitants/year), in 2017 (accrual period), patients with a new in-hospital diagnosis of NSCLC (i.e., excluding those diagnosed back up to 2013), at stage I-III (i.e., excluding those with distant metastases at the first diagnosis and/or within 60 following days), and resected (i.e., with ≥1 in-hospital surgery within 6 months from the first diagnosis), were identified. The cohort was characterized by age, sex and comorbidities. The dispensation of neoadjuvant therapy (≥1 radio and/or chemotherapy session) between the first diagnosis and surgery was analyzed. Within 2 years after surgery, overall survival-OS and progression free survival-PFS (Kaplan Meier analyses), and healthcare integrated costs charged to the INHS (pharmaceuticals, hospitalizations, specialist/outpatient services) were described. Results: In 2017, of 2440 (incidence 52.1 x100,000) newly NSCLC diagnosed patients, 1605 were defined with stage I-III. Of these, 467 (29.1%) underwent surgery. They were mainly males (74.3%) and on average aged 69±10. Arterial hypertension (64.7%), chronic lung diseases (46.7%) and dyslipidaemia (36.0%) were the most frequent comorbidities. Lung lobectomy (highest mean length of in-hospital stay: 11 days) was the most common surgery (296/467; 63.4%). Before surgery, 48/467 patients (10.3%) received neoadjuvant therapy. During the 2 nd year after surgery, 418/467 patients (89.5%) were analysable. At 2 years after surgery, OS was 81.6% and increased with age, while PFS was 59.8%. On average: within 1 year, the INHS spent € 20,942 per capita (hospitalizations – including first hospitalization - accounted for 56.3%, and pharmaceuticals for 35% of the total cost); within the 2 nd year, the INHS expenditure was € 9,851 per capita (pharmaceuticals weighed 65.8% of the overall cost, and hospitalizations 19.8%). Conclusions: Italian administrative healthcare data can identify and describe newly NSCLC diagnosed patients with stage I-III and resected, quantify their burden on the INHS and show a substantial survival benefit.