SEER database analysis of trends in long-term survival among patients with de novo metastatic cancer

Analysis of the SEER database evaluated changes in 5-year overall survival (OS) among patients with de novo metastatic cancer diagnosed in 1976 versus 2015, with a minimum of 5 year follow-up. The database provided data on 11,864 patients diagnosed with de novo metastatic cancer in 1976 and 26,324 patients diagnosed in 2015. The 5-year OS increased significantly from 10.6% in the 1976-cohort to 23.6% in the 2015-cohort (p<0.001). Survival gains were largest in breast cancer (12.6% to 34.2%; pxtagstartz0.001), ovarian cancer (14.4% tot 32.5%; p<0.001), colorectal cancer (3.7% to 15.0%), and hematologic malignancies (24.3% to 53.9%; p<0.001), whereas minimal improvement occurred in pancreatic cancer (0.25% to 1.6%; p=0.007) and small cell lung cancer (0.8% to 3.1%; p=0.008). Multivariable analysis demonstrated that older age, male sex, and Black race were associated with lower odds of 5 year survival (all p<0.01). The authors conclude that over the past four decades, long-term survival among patients with de novo metastatic cancer has more than doubles; however, progress remains uneven across cancer types.