Prognostic factors for stage III/IV bronchopulmonary cancers in the North-West region of Tunisia

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Published Apr 1, 2026
https://doi.org/10.62438/tunismed.v104i02.5881
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Vol. 104 No. 02 (2026): Tunis Med Fev 2026

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Najet Mahjoub
Medical Carcinology Service, Sectoral Center for Cancerous Diseases of Jendouba, El Manar University Tunis, Faculty of Medicine of Tunis, Tunisia.
Houyem Khiari
Epidemiology Service, Salah Azaiez Institute Tunis, Faculty of Medicine of Tunis, El Manar University Tunis, Tunisia.
Aroua Slama
Medical Carcinology Service, Sectoral Center for Cancerous Diseases of Jendouba, El Manar University Tunis, Faculty of Medicine of Tunis, Tunisia.
Samia Ben Hssine
Radiotherapy Center, Sectoral Center for Cancer Diseases of Jendouba, Faculty of Medicine of Tunis, El Manar University Tunis, Tunisia.
Sabrine Boukhriss
Cancer surgery department, Jendouba regional hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.
Rania Fehri
Medical Carcinology Service, Sectoral Center for Cancerous Diseases of Jendouba, El Manar University Tunis, Faculty of Medicine of Tunis, Tunisia.
Rim Rjiba
Medical Carcinology Service, Sectoral Center for Cancerous Diseases of Jendouba, El Manar University Tunis, Faculty of Medicine of Tunis, Tunisia.
Hajeur Jaffel
Radiotherapy Center, Sectoral Center for Cancer Diseases of Jendouba, Faculty of Medicine of Tunis, El Manar University Tunis, Tunisia.

Abstract

Introduction: Non-small cell bronchopulmonary cancer is a pathology of major severity on a global scale. In Tunisia, NSCLC represents the leading
cancer in men. Despite diagnostic and therapeutic progress, the prognosis remains reserved. This poor prognosis could be explained in part by the
advanced stage of the disease at the time of diagnosis.
Aim: To identify the prognostic factors of NSCLC at advanced stages (III and IV) and to study their impacts on overall survival.
Methods: This was a retrospective study conducted over a period of 8 years 11 months from January 2013 to December 2020 and which collected 95 patients with advanced stage III/IV non-small cell bronchopulmonary cancer treated at the medical oncology department at the Sectorial Center for Cancer Diseases in Jendouba.
Results: The mean age was 64 years. The sex ratio was 9.6 with a male predominance (91%). The most common reason for consultation was cough
(26%), followed by chest pain (21%). Five percent of patients presented with an emergency presentation (intracranial hypertension, spinal cord
compression, and superior vena cava syndrome). The two main histological types were adenocarcinoma (54%) followed by squamous cell carcinoma in 39% of cases. At the end of the extension assessment, locally advanced stage IIIB observed in 30 patients (31.6%). For metastatic stages, stage IVB observed in 31 patients (32.6%). In terms of treatment, 7.4% of patients had received primary surgery, 46 patients had received radiotherapy, either curative or palliative depending on the indications....( abstract truncated at 250 words)


 

Keywords:

Non-small cell lung cancer, treatment, survival, prognosis

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References

  1. Lung cancer [Internet]. [cité 10 janv 2025]. Disponible sur: https://www.who.int/news-room/fact-sheets/detail/lung-cancer
  2. Gobrane HLB, Hajjem S, Aounallah-Skhiri H, Achour N, Hsairi M. Mortalité par cancer en Tunisie: calcul des années de vies perdues. Santé publique. 2011;23(1):31-40.
  3. Garinet S, Wang P, Mansuet-Lupo A, Fournel L, Wislez M, Blons H. Updated Prognostic Factors in Localized NSCLC. Cancers (Basel). 9 mars 2022;14(6):1400.
  4. Menon T, Gopal S, Rastogi Verma S. Targeted therapies in non-small cell lung cancer and the potential role of AI interventions in cancer treatment. Biotechnol Appl Biochem. févr 2023;70(1):344-56.
  5. Alifano M, Giraud P. Quelles stratégies thérapeutiques pour les CBNPC de stade IIIA (T1-T3N2) ? Revue des Maladies Respiratoires Actualités. oct 2018;10(3):314-8.
  6. Amar JB, Safta BB, Zaibi H, Dhahri B, Baccar MA, Azzabi S. Facteurs pronostiques du cancer bronchique non à petites cellules localement avancé et métastatique Prognostic factors of advanced stage non-small-cell lung cancer. LA TUNISIE MEDICALE. 2016;94.
  7. Gargouri I, Jabli S, Knaz A, Benzarti W, Aissa S, Abdelghani A, et al. Délai de prise en charge thérapeutique du cancer broncho- pulmonaire localement avancé et métastatique et son impact sur la survie. Revue des Maladies Respiratoires. 1 janv 2019;36: A118.
  8. Del Prete C, Azzoli CG. Non-Small Cell Lung Cancer in the Era of Personalized Medicine: Molecular Tests that Matter. R I Med J(2013). 1 avr 2020;103(3):28-32.
  9. Kwas H, Guermazi E, Khattab A, Hrizi C, Zendah I, Ghédira H. Facteurs pronostiques du cancer bronchique non à petites cellules au stade avancé. Revue de Pneumologie Clinique. sept 2017;73(4):180-7.
  10. Cuyún Carter G, Barrett AM, Kaye JA, Liepa AM, Winfree KB, John WJ. A comprehensive review of nongenetic prognostic and predictive factors influencing the heterogeneity of outcomes in advanced non-small-cell lung cancer. Cancer Manag Res. 23 oct 2014;6:437-49.
  11. Loued L, Joobeur S, Migaou A, Braham Y, Fahem N, Harrathi C, et al. Survie et facteurs pronostiques du cancer bronchique non à petites cellules chez le sujet jeune. Revue des Maladies Respiratoires. 1 janv 2019;36:A204.
  12. Corre R, Le Caer H. Prise en charge du CBNPC chez les sujets âgés. Revue des Maladies Respiratoires Actualités. sept
  13. ;9(2):299-307.
  14. Defossez G, Uhry Z, Delafosse P, Dantony E, d’Almeida T, Plouvier S, et al. Cancer incidence and mortality trends in France over 1990– 2018 for solid tumors: the sex gap is narrowing. BMC Cancer. 24 juin 2021;21:726.
  15. Pinto JA, Vallejos CS, Raez LE, Mas LA, Ruiz R, Torres-Roman JS, et al. Gender and outcomes in non-small cell lung cancer: an old prognostic variable comes back for targeted therapy and immunotherapy? ESMO Open. 1 janv 2018;3(3):e000344.
  16. 788-tunisia-fact-sheet.pdf [Internet]. [cité 25 oct 2024]. Disponible sur: https://gco.iarc.who.int/media/globocan/factsheets/ populations/788-tunisia-fact-sheet.pdf
  17. Gester F, Paulus A, Sibille A, Corhay JL, Duysinx B, Louis R. FACTEURS PRONOSTIQUES DU CANCER PULMONAIRE NON À PETITES CELLULES. Rev Med Liège.
  18. Conforti F, Pala L, Bagnardi V, Pas TD, Martinetti M, Viale G, et al. Cancer immunotherapy efficacy and patients’ sex: a systematic review and meta-analysis. The Lancet Oncology. 1 juin 2018;19(6):737-46.
  19. Choubi M, Jabri H, Chaker K, El Khattabi W, Afif MH. Le carcinome bronchique non à petites cellules localement avancé : profil et facteurs pronostiques. Revue des Maladies Respiratoires. 1 janv 2017;34: A75-6.
  20. Hamdi M, Chermiti Ben Abdallah F, Belloumi N, Bachouch I, Habouria C, Fenniche S. Facteurs pronostiques du CBNPC métastatique : une analyse rétrospective de 160 patients. Revue des Maladies Respiratoires Actualités. 1 janv 2022;14:101.
  21. García-Pardo M, Chang A, Schmid S, Dong M, Brown MC, Christiani D, et al. Respiratory and Cardiometabolic Comorbidities and Stages I to III NSCLC Survival: A Pooled Analysis From the International
  22. Lung Cancer Consortium. Journal of Thoracic Oncology. 1 mars 2023;18(3):313-23.
  23. Thomas P, Herbreteau G, Sagan C, Raimbourg J, Denis M, Pons- Tostivint E. Influence de l’expression de PD-L1 sur la survie globale des patients atteints de CBNPC métastatique avec mutation EGFR,
  24. traités en première ligne avec l’osimertinib. Revue des Maladies Respiratoires Actualités. 1 janv 2024;16(1):263-4.
  25. Gee K, Yendamuri S. Lung cancer in females—sex-based differences from males in epidemiology, biology, and outcomes: a narrative review. Translational Lung Cancer Research [Internet]. 31 janv 2024
  26. [cité 16 oct 2024];13(1). Disponible sur: https://tlcr.amegroups. org/article/view/82771.
  27. Joobeur S, Mribah H, Saad AB, Mhamed SC, Mahou H, Rouatbi N, et al. Adénocarcinome pulmonaire primitif: expérience d’un centre hospitalier tunisien. Pan Afr Med J. 24 juill 2015;21:216.
  28. Moubachir H, El Khattabi W, Jabri H, Afif M. Évolution du type histologique du cancer bronchique non à petites cellules (CBNPC). Revue des Maladies Respiratoires. janv 2016;33:A102.
  29. Slim A, Kamoun H, Hadidene Y, Smadhi H, Meddeb A, Megdiche ML. Postoperative recurrence of primary lung cancer: anatomo-clinical and therapeutic study. Tunis Med. mai 2021;99(5):560-8.
  30. Jrad S, Belloumi N, Imene B, Hamdi M, Bougacha M, Baili H, et al. Facteurs pronostiques du cancer bronchopulmonaire au stade localement avancé non opérable. Revue des Maladies Respiratoires
  31. Actualités. 1 janv 2021;13(1):130-1.
  32. Paesmans M. Prognostic and predictive factors for lung cancer. Breathe. 1 déc 2012;9(2):112-21.
  33. Joobeur S, Ben Saad A, Migaou A, Fahem N, Mhamed SC, Rouatbi N. Survie et facteurs pronostiques du cancer bronchique non à petites cellules chez le sujet jeune au centre tunisien. Pan Afr Med J. 23 janv 2020;35:19.
  34. Chermiti Ben Abdallah F, Ben Ali G, Sadok Boudaya M, Mlika M, Chtourou A, Taktak S, et al. Traitement et pronostic du cancer bronchique non à petites cellules au stade avancé. Revue des Maladies Respiratoires. mars 2014;31(3):214-20.
  35. Lahmadi M, Beddar L, Ketit S, Makhbouche T, Laouar N, Filali T. Clinicopathological characteristics and prognosis of non-small cell lung cancer in Algeria: a single-center retrospective study. BMC Cancer. 2 août 2024;24(1):946.
  36. Petrella F, Rizzo S, Attili I, Passaro A, Zilli T, Martucci F, et al. Stage III Non-Small-Cell Lung Cancer: An Overview of Treatment Options. Curr Oncol. 7 mars 2023;30(3):3160-75.
  37. Formes localement avancées (stades IIIA non résécables, IIIB, IIIC) – AURA [Internet]. [cité 6 janv 2025]. Disponible sur: https:// referentiels-aristot.com/129-cancer-bronchique-non-petites-cellules/134-modalites-therapeutiques/137-formes-localement-avancees-stades-iiia-iiib-iiic/
  38. Le Garlantezec P, Vaylet F, Mullot H, Aupée O, Simon L, Lefeuvre L, et al. Le cancer broncho-pulmonaire non à petites cellules : point sur la pathologie et stratégie de décision thérapeutique. Le Pharmacien Hospitalier. 1 juin 2008;43(173):93-102.
  39. Vinod SK, Hau E. Radiotherapy treatment for lung cancer: Current status and future directions. Respirology. nov 2020;25(S2):61-71.
  40. Dillman RO, Herndon J, Seagren SL, Eaton WL, Green MR. Improved survival in stage III non-small-cell lung cancer: seven-year follow-up of cancer and leukemia group B (CALGB) 8433 trial. J Natl Cancer Inst. 4 sept 1996;88(17):1210-5.
  41. Aupérin A, Le Péchoux C, Rolland E, Curran WJ, Furuse K, Fournel P, et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol. 1 mai 2010;28(13):2181-90
  42. Alduais Y, Zhang H, Fan F, Chen J, Chen B. Non-small cell lung cancer (NSCLC): A review of risk factors, diagnosis, and treatment. Medicine [Internet]. 2 févr 2023 [cité 22 sept 2024];102(8). Disponible sur:
  43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309591/
  44. Fournel P, Desage AL, Bareille Saint-Gaudens A, Guillerm S, Zalcman G, Ricordel C. Traitement standard des stades III non résécables: Standard therapy for unresectable Stage III Non-Small Cell Lung
  45. Cancer. Revue des Maladies Respiratoires Actualités. 1 oct 2023;15(2, Supplement 1): eS34-47.
  46. Shroff GS, De Groot PM, Papadimitrakopoulou VA, Truong MT, Carter BW. Targeted Therapy and Immunotherapy in the Treatment of Non–Small Cell Lung Cancer. Radiologic Clinics of North America. mai 2018;56(3):485-95.
  47. De Ruysscher D, Ramalingam S, Urbanic J, Gerber DE, Tan DSW, Cai J, et al. CheckMate 73L: A Phase 3 Study Comparing Nivolumab Plus Concurrent Chemoradiotherapy Followed by Nivolumab With
  48. or Without Ipilimumab Versus Concurrent Chemoradiotherapy Followed by Durvalumab for Previously Untreated, Locally Advanced Stage III Non-Small-Cell Lung Cancer. Clin Lung Cancer. mai 2022;23(3):e264-8.