Miriam M Boxer1,2, Kirsten J Duggan3, Joseph Descallar4,2, Shalini K Vinod1,2,5. 1. Cancer Therapy Centre, Liverpool Hospital, Sydney, New South Wales, Australia. 2. South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia. 3. South West Sydney and Sydney Local Health Districts Clinical Cancer Registry, Liverpool Hospital, Sydney, New South Wales, Australia. 4. Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, New South Wales, Australia. 5. School of Medicine, University of Western Sydney, Sydney, New South Wales, Australia.
Abstract
AIM: Clinical guidelines provide evidence-based management recommendations to guide practice. This study aimed to evaluate whether patients discussed at a lung cancer multidisciplinary team meeting received guideline-recommended treatment and determine reasons for not receiving guideline-recommended treatment. METHODS: All new lung cancer patients discussed at the Liverpool/Macarthur lung cancer multidisciplinary team meeting between 1 December 2005 and 31 December 2010 were included. Guideline-recommended treatment was assigned according to pathology, stage and ECOG (Eastern Co-operative Oncology Group) performance status as per the 2004 Australian Lung Cancer Guidelines. This was compared with actual treatment received to determine adherence to guidelines. For those patients who did not receive guideline-recommended treatment, the medical record was reviewed to determine the reason(s) for this. Survival was compared between those who did and did not receive guideline-recommended treatment. RESULTS: 808 new patients were discussed at the multidisciplinary team meeting. Guideline-recommended treatment could not be assigned in 2% of patients due to missing data. 435 patients (54%) received guideline-recommended treatment, and 356 (44%) did not. The most common reasons for not receiving guideline-recommended treatment were a decline in ECOG performance status (24%), large tumor volume precluding radical radiotherapy (17%), comorbidities (15%) and patient preference (13%). Patients less than 70 years who received guideline-recommended treatment had improved survival compared with those who did not. CONCLUSIONS: A significant proportion of lung cancer patients did not receive guideline-recommended treatment due to legitimate reasons. Alternative guidelines are needed for patients not suitable for current best practice. Treatment according to guidelines was a predictor for survival.
AIM: Clinical guidelines provide evidence-based management recommendations to guide practice. This study aimed to evaluate whether patients discussed at a lung cancer multidisciplinary team meeting received guideline-recommended treatment and determine reasons for not receiving guideline-recommended treatment. METHODS: All new lung cancerpatients discussed at the Liverpool/Macarthur lung cancer multidisciplinary team meeting between 1 December 2005 and 31 December 2010 were included. Guideline-recommended treatment was assigned according to pathology, stage and ECOG (Eastern Co-operative Oncology Group) performance status as per the 2004 Australian Lung Cancer Guidelines. This was compared with actual treatment received to determine adherence to guidelines. For those patients who did not receive guideline-recommended treatment, the medical record was reviewed to determine the reason(s) for this. Survival was compared between those who did and did not receive guideline-recommended treatment. RESULTS: 808 new patients were discussed at the multidisciplinary team meeting. Guideline-recommended treatment could not be assigned in 2% of patients due to missing data. 435 patients (54%) received guideline-recommended treatment, and 356 (44%) did not. The most common reasons for not receiving guideline-recommended treatment were a decline in ECOG performance status (24%), large tumor volume precluding radical radiotherapy (17%), comorbidities (15%) and patient preference (13%). Patients less than 70 years who received guideline-recommended treatment had improved survival compared with those who did not. CONCLUSIONS: A significant proportion of lung cancerpatients did not receive guideline-recommended treatment due to legitimate reasons. Alternative guidelines are needed for patients not suitable for current best practice. Treatment according to guidelines was a predictor for survival.
Authors: Stuart Purdie; Nicola Creighton; Kahren Maree White; Deborah Baker; Dan Ewald; Chee Khoon Lee; Alison Lyon; Johnathan Man; David Michail; Alexis Andrew Miller; Lawrence Tan; David Currow; Jane M Young Journal: NPJ Prim Care Respir Med Date: 2019-02-08 Impact factor: 2.871
Authors: Abdul Rahman Jazieh; Khaled Al Kattan; Ahmed Bamousa; Ashwaq Al Olayan; Ahmed Abdelwarith; Jawaher Ansari; Abdullah Al Twairqi; Turki Al Fayea; Khalid Al Saleh; Hamed Al Husaini; Nafisa Abdelhafiez; Mervat Mahrous; Medhat Faris; Ameen Al Omair; Adnan Hebshi; Salem Al Shehri; Foad Al Dayel; Hanaa Bamefleh; Walid Khalbuss; Sarah Al Ghanem; Shukri Loutfi; Azzam Khankan; Meshael Al Rujaib; Majed Al Ghamdi; Nagwa Ibrahim; Abdulmonem Swied; Mohammad Al Kayait; Marie Datario Journal: Ann Thorac Med Date: 2017 Oct-Dec Impact factor: 2.219