过去10年来，非小细胞肺癌（NSCLC）的治疗一直在不断革新，然而，标准的临床试验可能不能及时反映出当前多种治疗方案和相应的结果。为了研究临床环境中新的NSCLC治疗的结果，本队列研究包括2010年1月1日至2020年11月30日在韩国三星医学中心接受任何抗癌治疗的NSCLC患者。数据分析于2021年11月至2022年2月进行。比较两个时期（期I：2010-2015 vs 期II：2016-2020）之间的临床病理分期、组织学和主要可药性序列变异，包括表皮生长因子受体（EGFR）、无形淋巴瘤激酶（ALK）、ROS1、RET、MET外显子14跳跃、BRAF V600E、KRAS G12C和NTRK。主要结局是NSCLC的3年生存率。次要结局包括中位总生存期、无进展生存期和无复发生存期。在21978名NSCLC患者中（诊断时年龄中位数[范围]为64.1 [57.0-71.0]岁；13624名男性[62.0％]），期I共有10110名患者，期II共有11868名患者；腺癌（AD）是主要的组织学类型（分别为7112名患者[70.3％]和8813名患者[74.3％]）。期I共有4224名从未吸烟的患者[41.8％]，期II共有5292名从未吸烟的患者[44.6％]。与期I相比，在AD（5678名患者[79.8％] vs 8631名患者[97.9％]）和非AD（2998名患者中的1612名[53.8％]和3055名患者中的2719名[89.0％]）组中，期II的患者更有可能接受分子检测。在期I中，AD患者的3年生存率分别为I期92.8％（95％ CI，91.8％-93.7％），II期72.4％（95％ CI，68.3％-76.8％），III期56.7％（95％ CI，53.4％-60.2％）和IV期28.7％（95％ CI，27.0％-30.4％）。在期II中，AD患者的3年生存率分别为I期95.1％（95％ CI，94.4％-95.9％），II期82.5％（95％ CI，79.1％-86.1％），III期65.1％（95％ CI，61.8％- 68.6％）和IV期42.4％（95％ CI，40.3％-44.7％）。在没有AD的患者中，期I的3年生存率分别为I期72.0％（95％ CI，68.8％-75.3％），II期60.0％（95％ CI，56.2％-64.1％），III期38.9％（95％ CI，35.6％-42.5％）和IV期9.7％（95％ CI，7.9％-12.1％）。在期II中，没有AD的患者的3年生存率分别为I期79.3％（95％ CI，76.3％-82.4％），II期67.3％（95％ CI，62.8％-72.1％），III期48.2％（95％ CI，44.5％-52.3％）和IV期18.1％（95％ CI，15.1％-21.6％）。在这个涵盖了10年临床数据的队列研究中，各阶段的生存结局均有改善，其中III期至IV期患者的增长更大。从未吸烟人群的发病率和分子检测的使用率增加了。

Over the past 10 years, treatment of non-small cell lung cancer (NSCLC) has been continually revolutionized. However, standard clinical trials may not reflect current multiple lines of treatment and corresponding outcomes in a timely manner.To investigate outcomes associated with new treatment of NSCLC in a clinical setting.This cohort study included patients with NSCLC between January 1, 2010, and November 30, 2020, who received any anticancer treatment at Samsung Medical Center in Korea. Data were analyzed from November 2021 through February 2022.Clinical and pathological stage, histology, and major druggable sequence variation, including epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), ROS1, RET, MET exon 14 skipping, BRAF V600E, KRAS G12C, and NTRK between 2 periods (period I: 2010-2015 vs period II: 2016-2020).The primary outcome was the 3-year survival rate of NSCLC. Secondary outcomes included median overall survival, progression-free survival, and recurrence-free survival.Among 21 978 patients with NSCLC (median [range] age at diagnosis, 64.1 [57.0-71.0] years; 13 624 males [62.0%]), there were 10 110 patients in period I and 11 868 patients in period II; adenocarcinoma (AD) was the predominant histology (7112 patients [70.3%] in period I and 8813 patients [74.3%] in period II). There were 4224 never smokers [41.8%] in period I and 5292 never smokers [44.6%] in period II. Compared with patients in period I, patients during period II were more likely to undergo molecular tests in the AD (5678 patients [79.8%] vs 8631 patients [97.9%]) and non-AD (1612 of 2998 patients [53.8%] and 2719 of 3055 patients [89.0%]) groups. In patients with AD in period I, 3-year survival rates were 92.8% (95% CI, 91.8%-93.7%), 72.4% (95% CI, 68.3%-76.8%), 56.7% (95% CI, 53.4%-60.2%), and 28.7% (95% CI, 27.0%-30.4%) for stage I, II, III, and IV, respectively. In period II, 3-year survival rates of patients with AD were 95.1% (95% CI, 94.4%-95.9%), 82.5% (95% CI, 79.1%-86.1%), 65.1% (95% CI, 61.8%-68.6%), and 42.4% (95% CI, 40.3%-44.7%) for each stage, respectively. In patients without AD, 3-year survival rates were 72.0% (95% CI, 68.8%-75.3%), 60.0% (95% CI, 56.2%-64.1%), 38.9% (95% CI, 35.6%-42.5%), and 9.7% (95% CI, 7.9%-12.1%) for each stage in period I. In period II, the 3-year survival rates of patients without AD were 79.3% (95% CI, 76.3%-82.4%), 67.3% (95% CI, 62.8%-72.1%), 48.2% (95% CI, 44.5%-52.3%), and 18.1% (95% CI, 15.1%-21.6%) for each stage.In this cohort study of 10 years of clinical data, survival outcomes were improved across all stages, with larger increases in patients with stage III to IV disease. The incidence of never-smokers and the use of molecular testing increased.