Emily Stone1, Nicole Rankin2, Stephen Kerr3, Kwun Fong4, David C Currow5, Jane Phillips5, Therese Connon6, Lorena Zhang7, Tim Shaw8. 1. St Vincent's Hospital Thoracic Medicine and Cancer Services, Kinghorn Cancer Centre, Australia; St Vincent's Clinical School, UNSW, Australia; Faculty of Medicine, University of Sydney, Australia. Electronic address: estone@meshastele.com.au. 2. Cancer Council NSW, Cancer Research Division University of Sydney, Sydney Health Partners, Office of the Pro-Vice Chancellor, Research in association with Charles Perkins Centre, University of Sydney, Faculty of Science, School of Psychology, Australia. 3. The Kirby Institute UNSW, Australia. 4. UQ Thoracic Research Centre, The Prince Charles Hospital, Brisbane QLD, Australia. 5. IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia. 6. Faculty of Medicine, University of Sydney, Australia. 7. Royal North Shore Hospital, Reserve Rd, St Leonards NSW 2065, Australia. 8. University of Sydney, Charles Perkins Centre, Australia.
Abstract
BACKGROUND: Multidisciplinary team (MDT) presentation in lung cancer has the potential to improve longterm outcomes, although this varies between studies. This study aims to evaluate outcomes including survival, according to MDT presentation and to explore the utility of data obtained from local clinical sources. PATIENTS AND METHODS: Prospective cases of lung cancer recorded in our institution's cancer registry were analyzed according to MDT presentation for patient and tumour characteristics, adjusted survival and referral to palliative care. RESULTS: 1197 cases were included, 295 (24.6%) with MDT presentation and 902 (75.4%) without. 60% of patients were male with median (IQR) age at diagnosis of 70 years (62-78). Histopathology distribution (non-small cell lung cancer and small-cell lung cancer) was similar between the two groups. Compared with the non-MDT group, the MDT group had (1) ECOG score recorded more often (71.9% vs. 47.6%), (2) higher proportion of ECOG 0 cases (31.2% vs. 11.9%) and ECOG 1 cases (28.8% vs. 20.3%), (3) higher proportion of early stage disease (stage I - 23.1% vs. 9.7% stage II - 10.2% vs. 4.8%, stage IIIA - 14.6% vs 6.3%) and (4) lower proportion of metastatic disease (stage IV - 39.3% vs. 56.1%). Referral to palliative care was incompletely recorded in both groups (MDT: n = 116/295, 39.3%; non-MDT: n = 430, 47.7%) but did not differ significantly for stage IV cases. Survival analyzed by stage was greater in the MDT group at 1, 2 and 5 years for all stages except stage IIIB at 1 year post-diagnosis. Adjusted survival analysis for the entire cohort showed improved survival at 5 years for the MDT group (HR 0.7 (0.58-0.85), p < 0.001). CONCLUSION: MDT presentation is associated with improved adjusted survival for lung cancer in this single institutional cohort in an analysis of local clinical cancer registry data.
BACKGROUND: Multidisciplinary team (MDT) presentation in lung cancer has the potential to improve longterm outcomes, although this varies between studies. This study aims to evaluate outcomes including survival, according to MDT presentation and to explore the utility of data obtained from local clinical sources. PATIENTS AND METHODS: Prospective cases of lung cancer recorded in our institution's cancer registry were analyzed according to MDT presentation for patient and tumour characteristics, adjusted survival and referral to palliative care. RESULTS: 1197 cases were included, 295 (24.6%) with MDT presentation and 902 (75.4%) without. 60% of patients were male with median (IQR) age at diagnosis of 70 years (62-78). Histopathology distribution (non-small cell lung cancer and small-cell lung cancer) was similar between the two groups. Compared with the non-MDT group, the MDT group had (1) ECOG score recorded more often (71.9% vs. 47.6%), (2) higher proportion of ECOG 0 cases (31.2% vs. 11.9%) and ECOG 1 cases (28.8% vs. 20.3%), (3) higher proportion of early stage disease (stage I - 23.1% vs. 9.7% stage II - 10.2% vs. 4.8%, stage IIIA - 14.6% vs 6.3%) and (4) lower proportion of metastatic disease (stage IV - 39.3% vs. 56.1%). Referral to palliative care was incompletely recorded in both groups (MDT: n = 116/295, 39.3%; non-MDT: n = 430, 47.7%) but did not differ significantly for stage IV cases. Survival analyzed by stage was greater in the MDT group at 1, 2 and 5 years for all stages except stage IIIB at 1 year post-diagnosis. Adjusted survival analysis for the entire cohort showed improved survival at 5 years for the MDT group (HR 0.7 (0.58-0.85), p < 0.001). CONCLUSION:MDT presentation is associated with improved adjusted survival for lung cancer in this single institutional cohort in an analysis of local clinical cancer registry data.
Authors: J R A Phillips; L Al-Mouazzen; R Morgan-Jones; J R Murray; A J Porteous; A D Toms Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-03-08 Impact factor: 4.342
Authors: Marius Freytag; Ulrich Herrlinger; Stefan Hauser; Franz G Bauernfeind; Maria A Gonzalez-Carmona; Jennifer Landsberg; Jens Buermann; Hartmut Vatter; Tobias Holderried; Thorsten Send; Martin Schumacher; Arne Koscielny; Georg Feldmann; Mario Heine; Dirk Skowasch; Niklas Schäfer; Benjamin Funke; Michael Neumann; Ingo G H Schmidt-Wolf Journal: BMC Cancer Date: 2020-04-28 Impact factor: 4.430