Interventions on Costs and Survival Rates of Lung Cancer Patients
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Submitted
11 June 2025
Published
30 November 2025
Keywords:
-
Lung Cancer, Intervention, Cost, Survival rate, Hospital
Abstract
Lung cancer is characterized by the uncontrolled growth of cells in the lung tissue, particularly in the lining of the respiratory tract. The disease has a high and alarming mortality rate, requiring prompt and appropriate management. This study aims to examine the costs and one-year survival rates of lung cancer patients at Dharmais Cancer Hospital. Data analysis was conducted in four stages: a retrospective observational study using secondary data from medical records, which described patient characteristics and factors affecting survival and treatment costs; analysis of survival curves by cancer stage and intervention; and testing differences in survival curves using the log-rank test. The results show that higher survival rates are often inversely proportional to shorter survival times, and vice versa. Stage 1 patients exhibited the most extended survival despite low survival rates for inpatients (48 months, 25%) and outpatients (53 months, 15%). Intervention types 4.00 (chemotherapy and radiotherapy) and 7.00 (chemotherapy, radiotherapy, and surgery) effectively extended survival, although associated survival rates remained low. The highest inpatient treatment costs were observed in stage 2 patients, while the highest annual outpatient costs were linked to surgical interventions, highlighting the difference between per-episode and cumulative annual expenditures.
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References
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2. Ramadhaniah F, Suzanna E, Syahruddin E, Shalmont G, Rahayu PS. National Lung Cancer Screening: Recommended Age for Screening. Indones J Cancer. 2024;18(4):517-22. DOI: 10.33371/ijoc.v18i4.1223
3. Tang FH, Wong HYT, Tsang PSW, Yau M, Tam SY, Law L, et al. Recent advancements in lung cancer research: a narrative review. Transl Lung Cancer Res. 2025;14(3):975-90. DOI: 10.21037/tlcr-24-979; PMCID: PMC12000946; PMID: 40248731
4. Yuliastuti F, Andayani TM, Endarti D, Kristina SA. Cost determinant of chemotherapy in breast, cervical, and lung cancer in the era of National Health Insurance. Pharm Pract. 2024;22(2):1-10. 10.18549/PharmPract.2024.2.2957
5. Dewi BA, Oetari O, Andayani TM. Cost Compliance Analysis of Real Therapy and INA-CBG’s of Chemotherapy Breast Cancer Inpatien at 2017 Dr. Moewardi Surakarta Hospital. STRADA J Ilmiah Kesehatan. 2021;10(1):1234–41. DOI: 10.30994/sjik.v10i1.543
6. Yuliastuti F, Andayani TM, Endarti D, Kristina SA. Breast, cervical, and lung cancer: A comparison of real healthcare costs and INA-CBGs rates in the era of national health insurance. Pharm Pract. 2023;21(1):2768. DOI: 10.18549/PharmPract.2023.1.2768; PMCID: PMC10117336; PMID: 37090448
7. Alfaqeeh M, Zakiyah N, Postma MJ, Suwantika AA. Setting priorities for healthcare interventions in Indonesia: a comprehensive conceptual framework. Int J Equity Health. 2025;24(1):327. DOI: 10.1186/s12939-025-02668-z; PMCID: PMC12642239; PMID: 41287082.
8. Wang C, Shao J, Song L, Ren P, Liu D, Li W. Persistent increase and improved survival of stage I lung cancer based on a large-scale real-world sample of 26,226 cases. Chin Med J. 2023;136(16):1937-48. DOI: 10.1097/CM9.0000000000002729; PMCID: PMC10431578; PMID: 37394562.
9. Soetandyo N, Hanafi AR, Agustini S, Sinulingga DT. Prognosis of advanced stage non-small-cell lung cancer patients receiving chemotherapy: adenocarcinoma versus squamous cell carcinoma. Med J Indones. 2020;29:26-31. DOI: 10.13181/mji.oa.203787
10. Farida Y, Maulida EA, Desinaini LN, Utami WD, Yuliati D. Breast Cancer Survival Analysis Using Cox Proportional Hazard Regression and Kaplan Meier Method. JTAM J Teori Aplikasi Matematika. 2021;5(2):340–58. DOI: 10.31764/jtam.v5i2.4653
11. Supartono, Suryanto A. Faktor-Faktor yang Mempengaruhi Ketahanan Hidup Satu Tahun Penderita Kanker Paru Stadium Lanjut di RSUP Dr. Kariadi Semarang. Med Hospitalia. 2012;1(1):25–31. DOI: 10.36408/mhjcm.v1i1.35
12. Megasari A, Bagiada M. Ketahanan Hidup 1 tahun Karsinoma Paru di Divisi Pulmonologi RSUP Sanglah Denpasar. J Medicina 2020;51(1):1–5. DOI: 10.15562/medicina.v51i1.323
13. Khaksar E, Askarishahi M, Hekmatimoghaddam S, Vahedian-Ardakani H. Cox Regression and Parametric Models: Comparison of How They Determine Factors Influencing Survival of Patients with Non-Small Cell Lung Carcinoma. Asian Pac J Cancer Prev. 2017;18(12):3389-93. DOI: 10.22034/apjcp.2017.18.12.3389; PMCID: PMC5980899; PMID: 29286608.
14. Inayati KD, Purnami SW. Analisis Survival Nonparametrik Pada Pasien Menggunakan Metode Kaplan Meier dan Uji Log Rank. J Sains Seni ITS. 2015;4(2):199–204. DOI: 10.24014/icopss.v2i1.25324
15. Li J, Xu HL, Li WX, Ma XY, Liu XH, Zhang ZF. Prognostic factors of survival in patients with lung cancer after low-dose computed tomography screening: a multivariate analysis of a lung cancer screening cohort in China. BMC Cancer. 2025;25(1):646. DOI: 10.1186/s12885-025-14036-9; PMCID: PMC11984240; PMID: 40205334.
16. Alfarisa S, Mitra E, Wahyuni S. Karakteristik Pasien Kanker Paru di RSUP Dr. M. Djamil Padang Tahun 2021. Sci J. 2023;2(6):247–55. DOI: 10.56260/sciena.v2i6.116
17. Filho AM, Laversanne M, Ferlay J, Colombet M, Piñeros M, Znaor A, et al. The GLOBOCAN 2022 cancer estimates: Data sources, methods, and a snapshot of the cancer burden worldwide. Int J Cancer. 2025;156(7):1336–46. DOI: 10.1002/ijc.35278; PMID: 39688499
18. Kristina SA, Krisnadewi KI, Trung VQ, Ramadhani A, Verdiana AS, Aryasatya MD. Cancer Burden Across The South East Asia Nation (ASEAN) in 2022. Asian Pac J Cancer Prev. 2025;26(9):3377-88. DOI: 10.31557/apjcp.2025.26.9.3377; PMID: 40952294
19. Önal Ö, Koçer M, Eroğlu HN, Yilmaz SD, Eroğlu I, Karadoğan D. Survival analysis and factors affecting survival in patients who presented to the medical oncology unit with non-small cell lung cancer. Turk J Med Sci. 2020;50(8):1838-50. DOI: 10.3906/sag-1912-205; PMCID: PMC7775717; PMID: 32512671.
20. Arumsari D, Martini S, Artanti KD, Widati S. The Description of Smoking Degree Based on Brinkman Index in Patientes with Lung Cancer. J Berkala Epidemiol. 2019;7(3):249–56. DOI: 10.20473/jbe.v7i32019
21. Doherty TM, Weinberger B, Didierlaurent A, Lambert PH. Age-related changes in the immune system and challenges for the development of age-specific vaccines. Ann Med. 2025;57(1):2477300. DOI: 10.1080/07853890.2025.2477300; PMCID: PMC11926906; PMID: 40110678.
22. Cupp J, Culakova E, Poniewierski MS, Dale DC, Lyman GH, Crawford J. Analysis of Factors Associated With In-hospital Mortality in Lung Cancer Chemotherapy Patients With Neutropenia. Clin Lung Cancer. 2018;19(2):e163–9. DOI: 10.1016/j.cllc.2017.10.013; PMID: 29233611
23. Hazell SZ, Mai N, Fu W, Hu C, Friedes C, Negron A, et al. Hospitalization and definitive radiotherapy in lung cancer: incidence, risk factors and survival impact. BMC Cancer. 2020;20(1):334. DOI: 10.1186/s12885-020-06843-z; PMCID: PMC7169027; PMID: 32306924
24. Shiraishi T, Oda K, Yamasaki K, Kido T, Sennari K, Mukae H, et al. Risk factors for in-hospital mortality in patients with advanced lung cancer with interstitial pneumonia undergoing systemic chemotherapy: A retrospective and observational study using a nationwide administrative database in Japan. Thorac Cancer. 2022;13(2):236–46. DOI: 10.1111/1759-7714.14254; PMCID: PMC8758426; PMID: 34865321
25. Zhang GZ, Jiao SC, Meng ZT. Pemetrexed plus cisplatin/carboplatin in previously treated locally advanced or metastatic non-small cell lung cancer patients. J Exp Clin Cancer Res. 2010;29(1):38. DOI: 10.1186/1756-9966-29-38; PMCID: PMC2876099; PMID: 20423465.
26. Masters GA, Temin S, Azzoli CG, Giaccone G, Baker S Jr, Brahmer JR, et al. Systemic Therapy for Stage IV Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2015;33(30):3488-515. DOI: 10.1200/JCO.2015.62.1342; PMCID: PMC5019421; PMID: 26324367.
27. Bi Z, Chen P, Liu YB, Zhao T, Sun X, Song XR, et al. Efficacy and safety analysis of paclitaxel, docetaxel and liposomal paclitaxel after neoadjuvant therapy in breast cancer. Breast Cancer Res Treat. 2020;184(2):397-405. DOI: 10.1007/s10549-020-05851-8; PMID: 32776291.
28. Miyamoto Y, Kozuki T, Aoe K, Wada S, Harada D, Yoshida M, et al. JME-001 phase II trial of first-line combination chemotherapy with cisplatin, pemetrexed, and nivolumab for unresectable malignant pleural mesothelioma. J Immunother Cancer. 2021;9(1):e003288. DOI: 10.1136/jitc-2021-003288; PMCID: PMC8557301; PMID: 34711664
29. Zhu YM, Gan YL, Xu HY, Chen WH, Dai HP. Clinical effectiveness of pemetrexed combined with cisplatin chemotherapy for advanced and maintenance treatment for patients with non-small-cell lung cancer. Eur Rev Med Pharmacol Sci. 2018;22(7):1943–7. DOI: 10.26355/eurrev_201804_14719; PMID: 29687847
30. Li J, Hu J, Yang Y, Zhang H, Liu Y, Fang Y, et al. Drug resistance in cancer: molecular mechanisms and emerging treatment strategies. Mol Biomed. 2025;6(1):111. doi: 10.1186/s43556-025-00352-w; PMCID: PMC12623568; PMID: 41247642.
31. Sharma DK, Saripilli R. Recent strategies in diagnosis, screening, prevention, and treatment of breast cancer in young women. Discov Oncol. 2025;16(1):1532. DOI: 10.1007/s12672-025-03180-0; PMCID: PMC12339843; PMID: 40789789.
32. Paesmans M. Prognostic and Predictive Factors for Lung Cancer. Breathe. 2012;9(2):113–22. DOI: 10.1183/20734735.006911.
33. Febriani A, Furqon A. Metastasis Kanker Paru. J Respirasi. 2018;4(3):94–101. DOI: 10.20473/jr.v4-I.3.2018.94-101
34. Vicidomini G. Current Challenges and Future Advances in Lung Cancer: Genetics, Instrumental Diagnosis and Treatment. Cancers. 2023;15(14):3710. DOI: 10.3390/cancers15143710; PMCID: PMC10377917; PMID: 37509371.
35. Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/1438/2023 tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana Kanker Paru. Jakarta: Kementerian Kesehatan Republik Indonesia; 2023.
36. Febriani A, Rahmawati Y. Efek Samping Hematologi Akibat Kemoterapi dan Tatalaksananya. J Respirasi. 2019;5(1):22–8. DOI: 10.20473/jr.v5-I.1.2019.22-28
37. Łazar-Poniatowska M, Bandura A, Dziadziuszko R, Jassem J. Concurrent chemoradiotherapy for stage III non-small-cell lung cancer: recent progress and future perspectives (a narrative review). Transl Lung Cancer Res. 2021;10(4):2018-31. DOI: 10.21037/tlcr-20-704; PMCID: PMC8107727; PMID: 34012811.
38. De Ruysscher D, Faivre-Finn C, Nackaerts K, Jordan K, Arends J, Douillard JY, et al. Recommendation for supportive care in patients receiving concurrent chemotherapy and radiotherapy for lung cancer. Ann Oncol. 2020;31(1):41-9. DOI: 10.1016/j.annonc.2019.10.003; PMID: 31912794.
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1.
Yuliastuti F, Kartikawati ND, Pradani MPK, Bunga CD, Mahato RK. Interventions on Costs and Survival Rates of Lung Cancer Patients. Borneo J Pharm [Internet]. 2025Nov.30 [cited 2025Dec.31];8(4):398-407. Available from: https://journal.umpr.ac.id/index.php/bjop/article/view/10049
Copyright (c) 2025 Fitriana Yuliastuti, Nurfina Dian Kartikawati, Missya Putri Kurnia Pradani, Cut Dewi Bunga, Roshan Kumar Mahato
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