Robert E Merritt1, Mahmoud Abdel-Rasoul2, Morgan Fitzgerald3, Desmond M D'Souza3, Peter J Kneuertz3. 1. Thoracic Surgery Division, Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address: robert.merritt@osumc.edu. 2. Center for Biostatistics, Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, Ohio. 3. Thoracic Surgery Division, Ohio State University Wexner Medical Center, Columbus, Ohio.
Abstract
BACKGROUND: Early-stage non-small cell lung cancer (NSCLC) is potentially curable with surgical resection. The overall survival rate for early-stage NSCLC may be determined by the healthcare facility type where patients receive their lung cancer treatment. METHODS: A total of 103,748 cases with the American Joint Committee on Cancer clinical stage I and II NSCLC that were reported to the National Cancer Database at over 1150 facilities were analyzed in this study. Healthcare facilities were dichotomized into the community and academic facility types. Marginal multivariable Cox proportional hazards models were used to evaluate differences in overall survival. Propensity score methodology with inverse probability of treatment weighting was used to adjust for facility volume and patient-related baseline differences between facility types. RESULTS: Patients with early-stage NSCLC who were treated at academic facility types had a significantly better median overall survival (63.2 months) compared with patients who received care at community healthcare facilities (54.2 months) (hazard ratio, 0.86; 95% confidence interval, 0.82-0.91; P < .0001). The surgical quality outcomes for NSCLC surgery, including 30-day mortality, 90-day mortality, and the median number of lymph nodes removed were significantly better for patients treated at the academic facility types. CONCLUSIONS: Patients with early-stage NSCLC who were treated at academic facility types had a significantly higher overall median survival compared with patients treated at community facility types. The short-term surgical quality outcomes were significantly better for patients who underwent surgery for early-stage NSCLC at academic facility types.
BACKGROUND: Early-stage non-small cell lung cancer (NSCLC) is potentially curable with surgical resection. The overall survival rate for early-stage NSCLC may be determined by the healthcare facility type where patients receive their lung cancer treatment. METHODS: A total of 103,748 cases with the American Joint Committee on Cancer clinical stage I and II NSCLC that were reported to the National Cancer Database at over 1150 facilities were analyzed in this study. Healthcare facilities were dichotomized into the community and academic facility types. Marginal multivariable Cox proportional hazards models were used to evaluate differences in overall survival. Propensity score methodology with inverse probability of treatment weighting was used to adjust for facility volume and patient-related baseline differences between facility types. RESULTS:Patients with early-stage NSCLC who were treated at academic facility types had a significantly better median overall survival (63.2 months) compared with patients who received care at community healthcare facilities (54.2 months) (hazard ratio, 0.86; 95% confidence interval, 0.82-0.91; P < .0001). The surgical quality outcomes for NSCLC surgery, including 30-day mortality, 90-day mortality, and the median number of lymph nodes removed were significantly better for patients treated at the academic facility types. CONCLUSIONS:Patients with early-stage NSCLC who were treated at academic facility types had a significantly higher overall median survival compared with patients treated at community facility types. The short-term surgical quality outcomes were significantly better for patients who underwent surgery for early-stage NSCLC at academic facility types.
Authors: Chelsea A Obrochta; Humberto Parada; James D Murphy; Atsushi Nara; Dennis Trinidad; Maria Rosario Happy Araneta; Caroline A Thompson Journal: PLoS One Date: 2022-10-05 Impact factor: 3.752
Authors: Huashan Shi; Kexun Zhou; Jordan Cochuyt; David Hodge; Hong Qin; Rami Manochakian; Yujie Zhao; Sikander Ailawadhi; Alex A Adjei; Yanyan Lou Journal: Front Oncol Date: 2021-12-10 Impact factor: 6.244