Emanuela Taioli1,2, Bian Liu2, Daniel G Nicastri1, Wil Lieberman-Cribbin2, Emanuele Leoncini3, Raja M Flores1. 1. Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York. 2. Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York. 3. Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy.
Abstract
BACKGROUND AND OBJECTIVES: Early stage lung cancer is generally treated with surgical resection. The objective of the study was to identify patient and hospital characteristics associated with the type of lung cancer surgical approach utilized in New York State (NYS), and to assess in-hospital adverse events. METHODS: A total of 33 960 lung cancer patients who underwent limited resection (LR) or lobectomy (L) were selected from the NYS Statewide Planning and Research Cooperative System database (1995-2012). RESULTS: LR patients were more likely to be older (adjusted odds ratio ORadj and [95% confidence interval]: 1.01 [1.01-1.02]), female (ORadj : 1.11 [1.06-1.16]), Black (ORadj : 1.17 [1.08-1.27]), with comorbidities (ORadj : 1.08 [1.03-1.14]), and treated in more recent years than L patients. Length of stay and complications were significantly less after LR than L (ORadj : 0.56 [0.53-0.58] and 0.65 [0.62-0.69]); in-hospital mortality was similar (ORadj : 0.93 [0.81-1.07]), and was positively associated with age and urgent/emergency admission, but inversely associated with female gender, private insurance, recent admission year, and surgery volume. CONCLUSIONS: There was a growing trend toward LR, which was more likely to be performed in older patients with comorbidities. In-hospital outcomes were better after LR than L, and were affected by patient and hospital characteristics.
BACKGROUND AND OBJECTIVES: Early stage lung cancer is generally treated with surgical resection. The objective of the study was to identify patient and hospital characteristics associated with the type of lung cancer surgical approach utilized in New York State (NYS), and to assess in-hospital adverse events. METHODS: A total of 33 960 lung cancerpatients who underwent limited resection (LR) or lobectomy (L) were selected from the NYS Statewide Planning and Research Cooperative System database (1995-2012). RESULTS: LR patients were more likely to be older (adjusted odds ratio ORadj and [95% confidence interval]: 1.01 [1.01-1.02]), female (ORadj : 1.11 [1.06-1.16]), Black (ORadj : 1.17 [1.08-1.27]), with comorbidities (ORadj : 1.08 [1.03-1.14]), and treated in more recent years than L patients. Length of stay and complications were significantly less after LR than L (ORadj : 0.56 [0.53-0.58] and 0.65 [0.62-0.69]); in-hospital mortality was similar (ORadj : 0.93 [0.81-1.07]), and was positively associated with age and urgent/emergency admission, but inversely associated with female gender, private insurance, recent admission year, and surgery volume. CONCLUSIONS: There was a growing trend toward LR, which was more likely to be performed in older patients with comorbidities. In-hospital outcomes were better after LR than L, and were affected by patient and hospital characteristics.