INTRODUCTION: A significant proportion of lung cancer patients receive no anticancer treatment. This varies from 19% in USA, 33% in Australia, 37% in Scotland, and 50% in Ireland. The aim of this study was to identify the reasons behind this. METHODS: The Lung Cancer Multidisciplinary Meeting (MDM) in South-West Sydney prospectively collects data on all patients presented. All new lung cancer patients presented between December 1, 2005, and December 31, 2007, were reviewed. Patients were assigned optimal treatment based on evidence-based guidelines. Those patients in whom guidelines recommended no treatment (GNT) were compared with those whom the MDM recommended no treatment (MNT) and with those who actually received no treatment (ANT). RESULTS: There were 335 patients with a median age of 69 years. A total of 82% had non-small cell lung cancer, 14% had small cell lung cancer, and 4% had no pathologic diagnosis. Eighty-five percent had locally advanced or metastatic disease. GNT was recommended in 4% (n = 13), MNT in 10% (n = 32) but ANT comprised 20% (n = 66). The differences between GNT and MNT were mainly due to patient comorbidities and clinician decision, but the differences between MNT and ANT were due to patient preference and declining performance status. In multivariate analysis, older age, poorer Eastern Cooperative Oncology Group status, non-small cell lung cancer, and non-English language predicted for ANT. CONCLUSIONS: The proportion of patients with lung cancer receiving no treatment is greater than that predicted by guidelines or recommended by the MDM but lower than that described in population-based studies suggesting that MDMs can improve treatment utilization in lung cancer.
INTRODUCTION: A significant proportion of lung cancerpatients receive no anticancer treatment. This varies from 19% in USA, 33% in Australia, 37% in Scotland, and 50% in Ireland. The aim of this study was to identify the reasons behind this. METHODS: The Lung Cancer Multidisciplinary Meeting (MDM) in South-West Sydney prospectively collects data on all patients presented. All new lung cancerpatients presented between December 1, 2005, and December 31, 2007, were reviewed. Patients were assigned optimal treatment based on evidence-based guidelines. Those patients in whom guidelines recommended no treatment (GNT) were compared with those whom the MDM recommended no treatment (MNT) and with those who actually received no treatment (ANT). RESULTS: There were 335 patients with a median age of 69 years. A total of 82% had non-small cell lung cancer, 14% had small cell lung cancer, and 4% had no pathologic diagnosis. Eighty-five percent had locally advanced or metastatic disease. GNT was recommended in 4% (n = 13), MNT in 10% (n = 32) but ANT comprised 20% (n = 66). The differences between GNT and MNT were mainly due to patient comorbidities and clinician decision, but the differences between MNT and ANT were due to patient preference and declining performance status. In multivariate analysis, older age, poorer Eastern Cooperative Oncology Group status, non-small cell lung cancer, and non-English language predicted for ANT. CONCLUSIONS: The proportion of patients with lung cancer receiving no treatment is greater than that predicted by guidelines or recommended by the MDM but lower than that described in population-based studies suggesting that MDMs can improve treatment utilization in lung cancer.
Authors: M D Goncalves; S Taylor; D F Halpenny; E Schwitzer; S Gandelman; J Jackson; A Lukose; A J Plodkowski; K S Tan; M Dunphy; L W Jones; R J Downey Journal: Clin Radiol Date: 2018-01-06 Impact factor: 2.350
Authors: Melisa L Wong; Timothy L McMurry; George J Stukenborg; Amanda B Francescatti; Carla Amato-Martz; Jessica R Schumacher; George J Chang; Caprice C Greenberg; David P Winchester; Daniel P McKellar; Louise C Walter; Benjamin D Kozower Journal: Lung Cancer Date: 2016-11-09 Impact factor: 5.705
Authors: Ya-Chen Tina Shih; Chun-Ru Chien; Rocio Moguel; Mike Hernandez; Richard A Hajek; Lovell A Jones Journal: Health Serv Res Date: 2015-06-26 Impact factor: 3.402
Authors: Kim-Son H Nguyen; Rachel A Sanford; Mark S Huberman; Michael A Goldstein; Danielle M McDonald; Mary Farquhar; Sidharta P Gangadharan; Michael S Kent; Gaetane Michaud; Adnan Majid; Stuart M Berman; Joseph A Aronovitz; Elena A Nedea; Phillip M Boiselle; David W Cohen; Susumu Kobayashi; Daniel B Costa Journal: J Oncol Pract Date: 2011-11-22 Impact factor: 3.840
Authors: Jemima T Collins; Simon Noble; John Chester; Helen E Davies; William D Evans; Jason Lester; Diane Parry; Rebecca J Pettit; Anthony Byrne Journal: BMC Cancer Date: 2015-07-24 Impact factor: 4.430
Authors: Jemima T Collins; Simon Noble; John Chester; Helen E Davies; William D Evans; Daniel Farewell; Jason F Lester; Diane Parry; Rebecca Pettit; Anthony Byrne Journal: Support Care Cancer Date: 2017-07-18 Impact factor: 3.603