Patients with de novo metastatic cancer have seen modest improvements in survival over the last 3 decades, according to researchers.

The survival improvements varied by tumor type, with the biggest survival gains seen in patients with gastrointestinal stromal tumors (GIST) and those with neuroendocrine tumors (NET). These findings were published in the Journal of the National Cancer Institute

This study included almost 2 million patients from the Netherlands Cancer Registry who were diagnosed with de novo metastatic solid tumors. Researchers compared 52,263 patients diagnosed during 1989-1993 with 84,383 patients diagnosed during 2014-2018. The patients had 28 different cancer types.


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The number of patients diagnosed with de novo metastatic disease increased over time for all cancers except stomach cancer and cancer of unknown primary.

Both 1-year and 5-year age-standardized net survival rates increased from 1989-1993 to 2014-2018 for most cancer types. The largest gains in 1-year net survival were seen in GIST (50%), NET (25%), and rectal (25%), colon (23%), and ovarian (21%) cancers. 

The smallest gains in 1-year net survival were seen in cancer of unknown primary (2%) and thyroid cancer (3%). In addition, patients with vulvar/vaginal cancer had a 27% decrease in 1-year net survival.

The largest gains in 5-year net survival were seen in GIST (46%), NET (32%), and prostate (19%), breast (18%), testicular (18%), and thyroid (17%) cancers. 

The smallest gains in 5-year net survival were seen for pancreatic, gallbladder, bile duct, stomach, and small cell lung cancers (1% for all). There were reductions in 5-year net survival for vulvar/vaginal cancer (3%), uterine cancer (2%), and head and neck squamous cell carcinoma (1%).

“Our results show that the survival of patients with de novo metastatic cancer improved slowly over 30 years but that these gains were typically modest and unevenly distributed among cancers,” the researchers concluded. “Next to better treatment options to improve survival in patients with metastatic cancer, we call for better preventive measures and early detection to reduce the incidence of metastatic disease.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Luyendijk M, Visser O, Blommestein HM, et al. Changes in survival in de novo metastatic cancer in an era of new medicines. J Natl Cancer Inst. Published online March 29, 2023. doi:10.1093/jnci/djad020