SUPPLEMENTARY TABLES.

Supplementary Table 1. Comparison of characteristics of study participants and non-participants

Characteristics / 447 with complete data / 422 with incomplete data / p-value1 / 309 with no QOL data / p-value2
n (%) / n (%) / n (%)
Age at diagnosis (years)
≤ 60 / 148 (33.1) / 131 (31.0) / 0.785 / 97 (31.4) / 0.410
61-69 / 152 (34.0) / 145 (34.4) / 96 (31.1)
≥ 70 / 147 (32.9) / 146 (34.6) / 116 (37.5)
Sex
Female / 224 (50.1) / 205 (48.6) / 0.651 / 152 (49.2) / 0.803
Male / 223 (49.9) / 217 (51.4) / 157 (50.8)
Race/Ethnicity
U.S. White / 409 (91.5) / 394 (93.4) / 0.299 / 267 (95.4) / 0.048
Other / 38 (8.5) / 28 (6.6) / 13 (4.6)
Education (years)
≤ 12 / 188 (42.6) / 232 (57.0) / <0.001 / 168 (65.6) / <0.001
13-16 / 159 (36.1) / 115 (28.3) / 65 (25.4)
> 16 / 94 (21.3) / 60 (14.7) / 23 (9.0)
Smoking status
Never smoker / 82 (18.3) / 49 (11.7) / 0.007 / 32 (11.9) / <0.001
Former smoker / 240 (53.7) / 221 (52.9) / 107 (39.8)
Current smoker / 125 (28.0) / 148 (35.4) / 130 (48.3)
Smoker (unknown former or current) / 0 / 4 / 37
TNM Stage
I / 290 (67.8) / 237 (59.9) / 0.054 / 188 (66.7) / 0.478
II / 49 (11.5) / 55 (13.9) / 26 (9.2)
III / 72 (16.8) / 75 (18.9) / 51 (18.1)
IV / 17 (4.0) / 29 (7.3) / 17 (6.0)
Histology
Adeno/BAC / 240 (53.7) / 219 (51.9) / 0.008 / 147 (47.9) / <0.001
Squamous / 95 (21.3) / 107 (25.4) / 99 (32.3)
Other NSCLC / 35 (7.8) / 46 (10.9) / 33 (10.8)
Small Cell / 18 (4.0) / 22 (5.2) / 11 (3.6)
Carcinoid/Salivary / 59 (13.2) / 28 (6.6) / 17 (5.5)
Primary Treatment
None3 / 1 (0.22) / 0 (0.00) / 0.332 / 11 (4.3) / <0.001
Surgery / 424 (94.9) / 367 (87.4) / <0.001 / 225 (86.9) / <0.001
Chemotherapy / 120 (26.9) / 129 (30.7) / 0.208 / 41 (15.8) / <0.001
Radiation / 101 (22.6) / 110 (26.2) / 0.218 / 39 (15.1) / 0.016
Overall QOL Mean (SD)4
All years average responses / 77.4 (15.9) / 72.6 (20.4) / 0.003 / - / -
<3 year responses / 80.6 (17.8) / 76.4 (20.3) / 0.037 / - / -
>5 year responses / 74.3 (19.6) / 71.6 (22.5) / 0.265 / - / -

1 Testing differences between the 447 set and the 422 set (participants without

complete QOL information).

2 Testing differences between the 447 set and the 309 set (participants who did not

participate in any follow-up).

3 Patients may have also had other treatments in addition to surgery, chemo, and

radiation.

4 Using the average of all overall QOL responses for each participant (Wilcoxon rank sum

test).

Supplementary Table2. Lungcancerfeatures andcomorbidities of 447 long-term survivors /
/ Female N=224 (50.1%) / Male N=223 (40.9%) / Total N=447 / p value
(F vs. M) /
Celltype Adenocarcinoma / 123 (54.9) / 117 (52.5) / 240 (53.7) / <0.01
Squamous cell carcinoma / 31 (13.8) / 64 (28.7) / 95 (21.3)
Othernon-small cell lung cancer1 / 20 (8.9) / 15 (6.7) / 35 (7.8)
Smallcell / 9 (4.0) / 9 (4.0) / 18 (4.0)
Carcinoid/Salivary / 41 (18.3) / 18 (8.1) / 59 (13.2)
GradeWelldifferentiated / 108 (48.2) / 78 (35.0) / 186 (41.6) / 0.04
Moderatelydifferentiated / 65 (29.0) / 84 (37.7) / 149 (33.3) / 0.03*
Poorly/Undifferentiated / 49 (21.9) / 58 (26.0) / 107 (23.9)
Non-gradable / 2 (0.9) / 3 (1.3) / 5 (1.1)
Stage (non-small cell)I / 145 (67.8) / 145 (67.8) / 290 (67.8) / 0.87
II / 26 (12.1) / 23 (10.7) / 49 (11.4)
III / 36 (16.8) / 36 (16.8) / 72 (16.8)
IV / 7 (3.3) / 10 (4.7) / 17 (4.0)
TumorfactorT0-1 / 136 (62.7) / 109 (50.5) / 245 (56.6) / <0.01
T2 / 52 (24.0) / 81 (37.5) / 133 (30.7)
T3-4 / 29 (13.4) / 26 (12.0) / 55 (12.7)
NodalinvolvementN0 / 163 (75.8) / 161 (75.6) / 324 (75.7) / 0.96
N1-3 / 52 (24.2) / 52 (24.4) / 104 (24.3)
Progression/recurrence/2nd primary1
None (disease-free) / 184 (82.1) / 179 (80.3) / 363 (81.2) / 0.55
Within3years (disease –bearing) / 26 (11.6) / 24 (10.8) / 50 (11.2)
Beyond3years (disease-bearing) / 14 (6.3) / 20 (9.0) / 34 (7.6)
Othercancer2No / 149 (68.3) / 119 (55.1) / 268 (61.8) / <0.01
Yes / 69 (31.7) / 97 (44.9) / 166 (38.2)
COPD3No / 122 (55.7) / 110 (50.9) / 232 (53.3) / 0.32
Yes / 97 (44.3) / 106 (49.1) / 203 (46.7)
AsthmaNo / 182 (83.5) / 184 (85.2) / 366 (84.3) / 0.63
Yes / 36 (16.5) / 32 (14.8) / 68 (15.7)
Otherpulmonarydisease4No / 148 (67.9) / 140 (64.8) / 288 (66.4) / 0.50
Yes / 70 (32.1) / 76 (35.2) / 146 (33.6)
DiabetesNo / 194 (89.0) / 184 (85.2) / 378 (87.1) / 0.24
Yes / 24 (11.0) / 32 (14.8) / 56 (12.9)
HeartdiseaseNo / 168 (77.1) / 126 (58.3) / 294 (67.7) / <0.01
Yes / 50 (22.9) / 90 (41.7) / 140 (32.3)
HypertensionNo / 128 (58.7) / 138 (63.9) / 266 (61.3) / 0.27
Yes / 90 (41.3) / 78 (36.1) / 168 (38.7)
StrokeNo / 192 (88.1) / 198 (91.7) / 390 (89.9) / 0.22
Yes / 26 (11.9) / 18 (8.3) / 44 (10.1)
Othernon-pulmonarydisease5No / 81 (37.2) / 92 (42.6) / 173 (39.9) / 0.25
Yes / 137 (62.8) / 124 (57.4) / 261 (60.1)
*Fisher’s Exact Test for small expected cell counts.
1 Defined as having multiple lung cancer events (i.e., additional primaries, recurrences,
and/or progressions).
2 Includes bladder, bone, brain, breast, cervical, colon, esophageal, gallbladder, head &
neck, kidney, leukemia, liver, lymphoma, melanoma, non-melanoma skin, oral, ovarian,
pancreatic, prostate, rectal, testicular, thyroid, uterine, and other unspecified cancers.
3 Includes chronic bronchitis, emphysema, and unspecified chronic obstructive pulmonary
diseases.
4 Includes acute bronchitis, unspecified bronchitis, idiopathic pulmonary fibrosis,
pneumonia, tuberculosis, and other unspecified pulmonary diseases.
5 Includes back problems, gastro-intestinal disease, gout, hemiplegia, kidney disease,
liver disease, peripheral vascular disease, rheumatoid arthritis, unspecified arthritis, and
other unspecified diseases.
/ Supplementary Table3. Lungcancer treatment modalities of 447 long-term survivors /
/ Female N=224 (50.1%) / Male N=223 (40.9%) / Total N=447 / p value /
Treatment1 / 0.32
No / 1 ( 0.4) / 0 ( -) / 1 ( 0.2) / 1.00*
Yes / 223 (99.6) / 223 (100) / 446 (99.8)
Surgery / 0.53
No / 13 ( 5.8) / 10 ( 4.5) / 23 ( 5.1)
Yes / 211 (94.2) / 213 (95.5) / 424 (94.9)
only surgery / 153 (68.3) / 149 (66.8) / 302 (67.6)
plus chemotherapy / 22 (9.8) / 18 (8.1) / 40 (8.9)
plus radiotherapy / 9 (4.0) / 14 (6.3) / 23 (5.1)
plus both / 27 (12.1) / 32 (14.3) / 59 (13.2)
Chemotherapy / 0.98
No / 164 (73.2) / 163 (73.1) / 327 (73.2)
Yes / 60 (26.8) / 60 (26.9) / 120 (26.8)
only chemotherapy / 1 (0.4) / 2 (0.9) / 3 (0.7)
plus only radiotherapy / 10 (4.5) / 8 (3.6) / 18 (4.0)
Radiation / 0.41
No / 177 (79.1) / 169 (75.8) / 346 (77.4)
Yes / 47 (21.0) / 54 (24.2) / 101 (22.6)
only radiotherapy / 1 (0.4) / 0 (0.0) / 1 (0.2)
* Fisher’s Exact Test for small expected cell counts.
1 Surgery, chemotherapy, and/or radiotherapy.


Supplementary Table 4. Factors associated with overall QOL at two time points (linear regression).

<3 year post diagnosis1 / ≥5 year post diagnosis2
Parameters / Coefficient (95% CI) / p-value / Coefficient (95% CI) / p-value
Intercept / 15.71 (7.28, 24.14) / <0.001 / 32.41 (23.63, 41.19) / <0.001
Age at diagnosis(vs. < 55)
55-74 / 0.06 (-2.85, 2.97) / 0.967 / -2.42 (-6.16, 1.33) / 0.205
≥ 75 / -5.14 (-8.96, -1.32) / 0.008 / -7.83 (-12.70, -2.96) / 0.002
Pack-years (vs. < 10)
10-29 / -1.28 (-4.51, 1.96) / 0.439 / -4 / -
30-49 / -1.53 (-4.85, 1.79) / 0.366 / - / -
≥ 50 / -3.16 (-6.32, 0.00) / 0.050 / - / -
Cell type (vs. adeno/BAC)
Squamous / -3.29 (-5.99, -0.59) / 0.017 / - / -
Other NSCLC / 1.79 (-2.22, 5.81) / 0.380 / - / -
Small cell / -0.56 (-6.55, 5.43) / 0.855 / - / -
Carcinoid/Salivary / -0.10 (-3.60, 3.40) / 0.955 / - / -
Surgery (vs. none)
Yes / - / - / 6.22 (0.15, 12.29) / 0.045
Chemotherapy (vs. none)
Yes / -2.82 (-5.46, -0.17) / 0.037 / - / -
Fatigue subscale (CID3) / 2.85 (2.15, 3.56) / <0.001 / 4.38 (3.70, 5.05) / <0.001
Dyspnea subscale (CID) / 1.27 (0.60, 1.94) / <0.001 / - / -
Pain subscale (CID) / 4.22 (3.53, 4.91) / <0.001 / 1.85 (1.18, 2.53) / <0.001

1 This model is based on 444 of the 447 (99.3%) participants due to missing information.

2 This model is based on 445 of the 447 (99.6%) participants due to missing information.

3 A 10-point drop on a 100-point scale.

4 Not a significant factor in this model.

CID = Clinically important decline.


Supplementary Table 5. Factors associated with a change over time in overall QOL (logistic regression)

Declined QOL1 / Improved QOL2
Characteristics / OR (95% CI) / p-value / OR (95% CI) / p-value
Sex (vs. female)
Male / -3 / - / 1.93 (1.05, 3.54) / 0.035
Years of education (vs. ≤ 12)
13-16 / 0.89 (0.55, 1.45) / 0.647 / 0.68 (0.36, 1.30) / 0.240
> 16 / 1.90 (1.09, 3.31) / 0.025 / 0.38 (0.16, 0.92) / 0.032
Pack-years (vs. < 10)
10-29 / - / - / 2.95 (1.18, 7.35) / 0.021
30-49 / - / - / 1.84 (0.73, 4.68) / 0.198
≥ 50 / - / - / 1.54 (0.63, 3.74) / 0.345
Non-lung disease (vs. none)
Yes / - / - / 2.54 (1.05, 6.10) / 0.038
Fatigue subscale (vs. other)
Declined1 / Improved2 / 3.56 (2.31, 5.49) / <0.001 / 3.32 (1.60, 6.88) / 0.001
Dyspnea subscale (vs. other)
Declined1 / Improved2 / - / - / 2.93 (1.45, 5.92) / 0.003
Pain subscale (vs. other)
Declined1 / Improved2 / 2.38 (1.56, 3.63) / <0.001 / 5.18 (2.53, 10.62) / <0.001

1 Declined QOL is defined as a >10 point decline from ≤3 year QOL to ≥5 year QOL.

The same measure of decline was used for the subscale covariates. This model is

based on 443 of the 447 (99.1%) participants due to missing information on the included

subscales.

2 Improved QOL is defined as a >10 point improvement from ≤3 year QOL to ≥5 year

QOL. The same measure of improvement was used for the subscale covariates. This

model is based on 442 of the 447 (98.9%) participants due to missing information on the

included subscales.

3 Not a significant factor in this model.

Supplementary Table 6. Comparison of characteristics that potentially bias overall QOL

Characteristics1 / N / Overall QOL2 / p-value3
Mean (SD)
Education (years)
≤ 12 / 188 / 75 (16) / 0.043
13-16 / 159 / 79 (16)
> 16 / 94 / 80 (15)
Smoking
Never / 82 / 82 (14) / 0.005
Former / 240 / 77 (16)
Current / 125 / 75 (16)
Histology
Adeno/BAC / 240 / 80 (14) / <0.001
Squamous / 95 / 72 (17)
Other NSCLC / 35 / 75 (18)
Small Cell / 18 / 69 (16)
Carcinoid/Salivary / 59 / 80 (17)
Surgery
No / 23 / 69 (17) / 0.009
Yes / 424 / 78 (16)

1 Group with bold font was overrepresented in the participants who reported better QOL.

2Using the average of all overall QOL responses for each participant.

3 Kruskal-Wallis test.

Supplementary Figures

Supplementary Figure 1A. Change in overall QOL over time for 447 long-term survivors

Supplementary Figure 1B. Change in overall QOL over time for 363 disease-free survivors

Supplementary Figure 1C. Change in overall QOL over time for 84 disease-bearing

survivors

Supplementary Figures

Supplementary Figure 1A.

Supplementary Figure 1B.

Supplementary Figure 1C.

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