F Pinquié1, F Goupil2, J-P Oster3, A Dixmier4, P-A Renault5, A Lévy6, J-P Mathieu7, N Paillot8, F C Goutorbe9, P Masson10, O Molinier1, D Debieuvre11, M Grivaux12. 1. Service de pneumologie, centre hospitalier du Mans, 72000 Le Mans, France. 2. Service de pneumologie, centre hospitalier du Mans, 72000 Le Mans, France. Electronic address: fgoupil@ch-lemans.fr. 3. Service de pneumologie, hôpitaux civils de Colmar, hôpital Pasteur, 68000 Colmar, France. 4. Service de pneumologie, centre hospitalier d'Orléans, hôpital de la Source, 45000 Orléans, France. 5. Service de pneumologie, centre hospitalier général de Pau, 64000 Pau, France. 6. Service de pneumologie, centre hospitalier Jacques-Cœur, 18000 Bourges, France. 7. Service de pneumologie, centre hospitalier de la Côte-Basque, 64100 Bayonne, France. 8. Service de pneumologie, centre hospitalier régional de Metz-Thionville, 57000 Metz, France. 9. Service de pneumologie, centre hospitalier général de Béziers, 34500 Béziers, France. 10. Service de pneumologie, centre hospitalier de Cholet, 49280 Cholet, France. 11. Service de pneumologie, hôpital Émile-Muller, GHRMSA, 68100 Mulhouse, France. 12. Service de pneumologie, centre hospitalier de Meaux, 77100 Meaux, France.
Abstract
BACKGROUND: The aim of ESCAP-2011-CPHG, promoted by the French College of General Hospital Respiratory Physicians, was to describe therapeutic strategies in lung cancer in the first 2 years after diagnosis, in a real-life setting. This article focuses on patients undergoing surgical management of a non-small cell lung cancer (NSCLC). METHODS: A prospective multicentre study was conducted in 53 French general hospitals. For each patient with lung cancer diagnosed in 2010, a standardised form was completed following each change in treatment strategy up to 2 years after diagnosis. RESULTS: Overall, 3418 of the 3943 included patients had NSCLC. 741 patients (21.7%) underwent curative surgery (stage 0-II, IIIA, IIIB, and IV: 65%, 27%, 3% and 5%, respectively). The therapeutic strategy changed less often in surgical than non-surgical patients and average follow-up time was longer: 23.3 months (SD: 9.3) versus 10.4 months (SD: 9.5) for non-surgical patients. Among patients with a surgical first strategy (92.6% of surgical patients as a whole), 56.9% did not receive any other treatment, 34.7% received chemotherapy, 5.9% radio-chemotherapy, 2.6% radiotherapy. At the end of follow-up, 55.8% were still alive without any other strategy, 13.1% had died, and 31.1% had received at least one more strategy. Among patients with a surgical second strategy, 63% had received chemotherapy alone during the first strategy. CONCLUSIONS: ESCAP -2011- CPHG assessed everyday professional practice in the surgical management of NSCLC in general hospitals. It pointed out the discrepancies between current guidelines and the therapeutic strategies applied in real life conditions.
BACKGROUND: The aim of ESCAP-2011-CPHG, promoted by the French College of General Hospital Respiratory Physicians, was to describe therapeutic strategies in lung cancer in the first 2 years after diagnosis, in a real-life setting. This article focuses on patients undergoing surgical management of a non-small cell lung cancer (NSCLC). METHODS: A prospective multicentre study was conducted in 53 French general hospitals. For each patient with lung cancer diagnosed in 2010, a standardised form was completed following each change in treatment strategy up to 2 years after diagnosis. RESULTS: Overall, 3418 of the 3943 included patients had NSCLC. 741 patients (21.7%) underwent curative surgery (stage 0-II, IIIA, IIIB, and IV: 65%, 27%, 3% and 5%, respectively). The therapeutic strategy changed less often in surgical than non-surgical patients and average follow-up time was longer: 23.3 months (SD: 9.3) versus 10.4 months (SD: 9.5) for non-surgical patients. Among patients with a surgical first strategy (92.6% of surgical patients as a whole), 56.9% did not receive any other treatment, 34.7% received chemotherapy, 5.9% radio-chemotherapy, 2.6% radiotherapy. At the end of follow-up, 55.8% were still alive without any other strategy, 13.1% had died, and 31.1% had received at least one more strategy. Among patients with a surgical second strategy, 63% had received chemotherapy alone during the first strategy. CONCLUSIONS: ESCAP -2011- CPHG assessed everyday professional practice in the surgical management of NSCLC in general hospitals. It pointed out the discrepancies between current guidelines and the therapeutic strategies applied in real life conditions.
Authors: Clémence Legoupil; Didier Debieuvre; Aurelien Marabelle; Stefan Michiels; Raïssa Kapso; Benjamin Besse; Julia Bonastre Journal: ERJ Open Res Date: 2020-04-19