1
|
Seung SJ, Moldaver D, Hassan S, Syed I, Shanahan M, Liu G. Real-World Treatment Patterns and Survival Among Patients with Stage I-III, Non-Squamous, Non-Small Cell Lung Cancer Receiving Surgery as Primary Treatment. Oncol Ther 2024:10.1007/s40487-024-00268-5. [PMID: 38485888 DOI: 10.1007/s40487-024-00268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/27/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION Approximately half of patients with non-small cell lung cancer (NSCLC) present with early-stage disease at diagnosis. Real-world outcomes data are limited for this population but are of interest given recent and impending results from trials evaluating epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and immunotherapies in neoadjuvant, adjuvant, and perioperative settings. METHODS A retrospective, longitudinal, population-level study was conducted in patients diagnosed with resected stage I-III non-squamous NSCLC in Ontario, Canada, between April 2010 and March 2019. Study outcomes included patient characteristics and median overall survival (mOS), with stratification by disease stage and treatment exposure. Patients receiving EGFR-TKIs (assumed EGFR mutation-positive by proxy) were a key population of interest. RESULTS Among 8255 cases, 4881 had stage I, 2124 had stage II, and 1250 had stage III NSCLC at diagnosis. The mean patient age was 68 years; 53.5% were female. In the overall cohort, 19.6% received adjuvant chemotherapy. Receipt of adjuvant chemotherapy was associated with significantly longer mOS than not receiving such therapy: stage II (7.6 [95% confidence interval: 6.5-8.5] vs. 4.4 [4.0-4.9] years) or stage III (4.4 [3.6-5.1] vs. 2.7 [2.3-3.3] years), both p < 0.0001. Patients receiving treatment (EGFR-TKIs and chemotherapy) were assumed to have experienced disease recurrence/relapse; mOS was longer among those receiving an EGFR-TKI than among those receiving chemotherapy (2.3 [1.8-3.0] vs. 1.1 [1.0-1.3] years). CONCLUSION In Ontario, between 2010 and 2019, uptake of adjuvant therapy was low among patients with resected NSCLC, despite such therapy being associated with improved survival. Patients assumed to have recurred/relapsed had markedly reduced mOS, regardless of subsequent therapy, compared with those who did not relapse/recur. Novel peri-adjuvant treatment options are needed to enhance outcomes after lung resection.
Collapse
Affiliation(s)
- Soo Jin Seung
- HOPE Research Centre, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
| | - Daniel Moldaver
- AstraZeneca Canada Inc., 1004 Middlegate Road, Mississauga, ON, L4Y 1M4, Canada
| | - Shazia Hassan
- HOPE Research Centre, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Iqra Syed
- AstraZeneca Canada Inc., 1004 Middlegate Road, Mississauga, ON, L4Y 1M4, Canada
| | - MaryKate Shanahan
- AstraZeneca Canada Inc., 1004 Middlegate Road, Mississauga, ON, L4Y 1M4, Canada
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
| |
Collapse
|
2
|
Sheikh M, Virani S, Robbins HA, Foretova L, Holcatova I, Janout V, Lissowska J, Navratilova M, Mukeriya A, Ognjanovic M, Swiatkowska B, Zaridze D, Brennan P. Survival and prognostic factors of early-stage non-small cell lung cancer in Central and Eastern Europe: A prospective cohort study. Cancer Med 2023; 12:10563-10574. [PMID: 36952375 PMCID: PMC10225235 DOI: 10.1002/cam4.5791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/28/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Although early diagnosis and surgical resection of the tumor have been shown to be the most important predictors of lung cancer survival, long-term survival for surgically-resected early-stage lung cancer remains poor. AIMS In this prospective study we aimed to investigate the survival and prognostic factors of surgically-resected early-stage non-small cell lung cancer (NSCLC) in Central and Eastern Europe. METHODS We recruited 2052 patients with stage I-IIIA NSCLC from 9 centers in Russia, Poland, Serbia, Czech Republic, and Romania, between 2007-2016 and followed them annually through 2020. RESULTS During follow-up, there were 1121 deaths (including 730 cancer-specific deaths). Median survival time was 4.9 years, and the 5-year overall survival was 49.5%. In the multivariable model, mortality was increased among older individuals (HR for each 10-year increase: 1.31 [95% CI: 1.21-1.42]), males (HR:1.24 [1.04-1.49]), participants with significant weight loss (HR:1.25 [1.03-1.52]), current smokers (HR:1.30 [1.04-1.62]), alcohol drinkers (HR:1.22 [1.03-1.44]), and those with higher stage tumors (HR stage IIIA vs. I: 5.54 [4.10 - 7.48]). However, education, chronic obstructive pulmonary diseases (COPD), and tumor histology were not associated with risk of death. All baseline indicators of smoking and alcohol drinking showed a dose-dependent association with the risk of cancer-specific mortality. This included pack-years of cigarettes smoked (p-trend = 0.04), quantity of smoking (p-trend = 0.008), years of smoking (p-trend = 0.010), gram-days of alcohol drank (p-trend = 0.002), frequency of drinking (p-trend = 0.006), and years of drinking (p-trend = 0.016). CONCLUSION This study shows that the 5-year survival rate of surgically-resected stage I-IIIA NSCLC is still around 50% in Central and Eastern Europe. In addition to non-modifiable prognostic factors, lifetime patterns of smoking and alcohol drinking affected the risk of death and disease progression in a dose-dependent manner in this population.
Collapse
Affiliation(s)
- Mahdi Sheikh
- Genomic Epidemiology BranchInternational Agency for Research on Cancer (IARC/WHO)LyonFrance
| | - Shama Virani
- Genomic Epidemiology BranchInternational Agency for Research on Cancer (IARC/WHO)LyonFrance
| | - Hilary A. Robbins
- Genomic Epidemiology BranchInternational Agency for Research on Cancer (IARC/WHO)LyonFrance
| | - Lenka Foretova
- Department of Cancer Epidemiology & GeneticsMasaryk Memorial Cancer InstituteBrnoCzech Republic
| | - Ivana Holcatova
- Department of Public Health and Preventive Medicine, Second Faculty of MedicineCharles UniversityPragueCzech Republic
- Department of Oncology2nd Medical Faculty & University Hospital MotolPragueCzech Republic
| | | | - Jolanta Lissowska
- Department of Cancer Epidemiology and PreventionM. Sklodowska‐Curie National Research Institute of OncologyWarsawPoland
| | - Marie Navratilova
- Department of Cancer Epidemiology & GeneticsMasaryk Memorial Cancer InstituteBrnoCzech Republic
| | - Anush Mukeriya
- Department of Clinical EpidemiologyN.N. Blokhin National Medical Research Centre of OncologyMoscowRussia
| | - Miodrag Ognjanovic
- International Organization for Cancer Prevention and ResearchBelgradeSerbia
| | - Beata Swiatkowska
- Department of Environmental EpidemiologyNofer Institute of Occupational MedicinePoland
| | - David Zaridze
- Department of Clinical EpidemiologyN.N. Blokhin National Medical Research Centre of OncologyMoscowRussia
| | - Paul Brennan
- Genomic Epidemiology BranchInternational Agency for Research on Cancer (IARC/WHO)LyonFrance
| |
Collapse
|
3
|
Blum TG, Morgan RL, Durieux V, Chorostowska-Wynimko J, Baldwin DR, Boyd J, Faivre-Finn C, Galateau-Salle F, Gamarra F, Grigoriu B, Hardavella G, Hauptmann M, Jakobsen E, Jovanovic D, Knaut P, Massard G, McPhelim J, Meert AP, Milroy R, Muhr R, Mutti L, Paesmans M, Powell P, Putora PM, Rawlinson J, Rich AL, Rigau D, de Ruysscher D, Sculier JP, Schepereel A, Subotic D, Van Schil P, Tonia T, Williams C, Berghmans T. European Respiratory Society guideline on various aspects of quality in lung cancer care. Eur Respir J 2023; 61:13993003.03201-2021. [PMID: 36396145 DOI: 10.1183/13993003.03201-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/23/2022] [Indexed: 11/18/2022]
Abstract
This European Respiratory Society guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO (Patients, Intervention, Comparison, Outcomes) questions. The evidence was appraised in compliance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multidisciplinary Task Force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results. In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) integration of multidisciplinary teams and multidisciplinary consultations, 3) implementation of and adherence to lung cancer guidelines, 4) benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, and histological subtyping and molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) added value of early integration of palliative care teams or specialists, 7) advantage of integrating specific quality improvement measures, and 8) benefit of using patient decision tools. These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available.
Collapse
Affiliation(s)
- Torsten Gerriet Blum
- Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Valérie Durieux
- Bibliothèque des Sciences de la Santé, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Joanna Chorostowska-Wynimko
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - David R Baldwin
- Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK
| | | | - Corinne Faivre-Finn
- Division of Cancer Sciences, University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | | | | | - Bogdan Grigoriu
- Intensive Care and Oncological Emergencies and Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Georgia Hardavella
- Department of Respiratory Medicine, King's College Hospital London, London, UK
- Department of Respiratory Medicine and Allergy, King's College London, London, UK
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Neuruppin, Germany
| | - Erik Jakobsen
- Department of Thoracic Surgery, Odense University Hospital, Odense, Denmark
| | | | - Paul Knaut
- Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | - Gilbert Massard
- Faculty of Science, Technology and Medicine, University of Luxembourg and Department of Thoracic Surgery, Hôpitaux Robert Schuman, Luxembourg, Luxembourg
| | - John McPhelim
- Lung Cancer Nurse Specialist, Hairmyres Hospital, NHS Lanarkshire, East Kilbride, UK
| | - Anne-Pascale Meert
- Intensive Care and Oncological Emergencies and Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Robert Milroy
- Scottish Lung Cancer Forum, Glasgow Royal Infirmary, Glasgow, UK
| | - Riccardo Muhr
- Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | - Luciano Mutti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- SHRO/Temple University, Philadelphia, PA, USA
| | - Marianne Paesmans
- Data Centre, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | - Paul Martin Putora
- Departments of Radiation Oncology, Kantonsspital St Gallen, St Gallen and University of Bern, Bern, Switzerland
| | | | - Anna L Rich
- Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK
| | - David Rigau
- Iberoamerican Cochrane Center, Barcelona, Spain
| | - Dirk de Ruysscher
- Maastricht University Medical Center, Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
- Erasmus Medical Center, Department of Radiation Oncology, Rotterdam, The Netherlands
| | - Jean-Paul Sculier
- Intensive Care and Oncological Emergencies and Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Arnaud Schepereel
- Pulmonary and Thoracic Oncology, Université de Lille, Inserm, CHU Lille, Lille, France
| | - Dragan Subotic
- Clinic for Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Thierry Berghmans
- Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles (ULB), Brussels, Belgium
| |
Collapse
|
4
|
Identification of Key Biomarkers and Candidate Molecules in Non-Small-Cell Lung Cancer by Integrated Bioinformatics Analysis. Genet Res (Camb) 2023; 2023:6782732. [PMID: 36688087 PMCID: PMC9831708 DOI: 10.1155/2023/6782732] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 01/05/2023] Open
Abstract
Background Non-small cell lung cancer (NSCLC) is the most prevalent malignant tumor of the lung cancer, for which the molecular mechanisms remain unknown. In this study, we identified novel biomarkers associated with the pathogenesis of NSCLC aiming to provide new diagnostic and therapeutic approaches for NSCLC by bioinformatics analysis. Methods From the Gene Expression Omnibus database, GSE118370 and GSE10072 microarray datasets were obtained. Identifying the differentially expressed genes (DEGs) between lung adenocarcinoma and normal samples was done. By using bioinformatics tools, a protein-protein interaction (PPI) network was constructed, modules were analyzed, and enrichment analyses were performed. The expression and prognostic values of 14 hub genes were validated by the GEPIA database, and the correlation between hub genes and survival in lung adenocarcinoma was assessed by UALCAN, cBioPortal, String and Cytoscape, and Timer tools. Results We found three genes (PIK3R1, SPP1, and PECAM1) that have a clear correlation with OS in the lung adenocarcinoma patient. It has been found that lung adenocarcinoma exhibits high expression of SPP1 and that this has been associated with poor prognosis, while low expression of PECAM1 and PIK3R1 is associated with poor prognosis (P < 0.05). We also found that the expression of SPP1 was associated with miR-146a-5p, while the high expression of miR-146a-5p was related to good prognosis (P < 0.05). On the contrary, the lower miR-21-5p on upstream of PIK3R1 is associated with a higher surviving rate in cancer patients (P < 0.05). Finally, we found that the immune checkpoint genes CD274(PD-L1) and PDCD1LG2(PD-1) were also related to SPP1 in lung adenocarcinoma. Conclusions The results indicated that SPP1 is a cancer promoter (oncogene), while PECAM1 and PIK3R1 are cancer suppressor genes. These genes take part in the regulation of biological activities in lung adenocarcinoma, which provides a basis for improving detection and immunotherapeutic targets for lung adenocarcinoma.
Collapse
|
5
|
Smith S, Brand M, Harden S, Briggs L, Leigh L, Brims F, Brooke M, Brunelli VN, Chia C, Dawkins P, Lawrenson R, Duffy M, Evans S, Leong T, Marshall H, Patel D, Pavlakis N, Philip J, Rankin N, Singhal N, Stone E, Tay R, Vinod S, Windsor M, Wright GM, Leong D, Zalcberg J, Stirling RG. Development of an Australia and New Zealand Lung Cancer Clinical Quality Registry: a protocol paper. BMJ Open 2022; 12:e060907. [PMID: 36038161 PMCID: PMC9438055 DOI: 10.1136/bmjopen-2022-060907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Lung cancer is the leading cause of cancer mortality, comprising the largest national cancer disease burden in Australia and New Zealand. Regional reports identify substantial evidence-practice gaps, unwarranted variation from best practice, and variation in processes and outcomes of care between treating centres. The Australia and New Zealand Lung Cancer Registry (ANZLCR) will be developed as a Clinical Quality Registry to monitor the safety, quality and effectiveness of lung cancer care in Australia and New Zealand. METHODS AND ANALYSIS Patient participants will include all adults >18 years of age with a new diagnosis of non-small-cell lung cancer (NSCLC), SCLC, thymoma or mesothelioma. The ANZLCR will register confirmed diagnoses using opt-out consent. Data will address key patient, disease, management processes and outcomes reported as clinical quality indicators. Electronic data collection facilitated by local data collectors and local, state and federal data linkage will enhance completeness and accuracy. Data will be stored and maintained in a secure web-based data platform overseen by registry management. Central governance with binational representation from consumers, patients and carers, governance, administration, health department, health policy bodies, university research and healthcare workers will provide project oversight. ETHICS AND DISSEMINATION The ANZLCR has received national ethics approval under the National Mutual Acceptance scheme. Data will be routinely reported to participating sites describing performance against measures of agreed best practice and nationally to stakeholders including federal, state and territory departments of health. Local, regional and (bi)national benchmarks, augmented with online dashboard indicator reporting will enable local targeting of quality improvement efforts.
Collapse
Affiliation(s)
- Shantelle Smith
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Margaret Brand
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Susan Harden
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Lisa Briggs
- Victorian Lung Cancer Registry, Monash University, Clayton, Victoria, Australia
| | - Lillian Leigh
- Victorian Lung Cancer Registry, Monash University, Clayton, Victoria, Australia
| | - Fraser Brims
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Mark Brooke
- Lung Foundation Australia, Milton, Queensland, Australia
| | - Vanessa N Brunelli
- Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Collin Chia
- Department of Respiratory Medicine, Launceston General Hospital, Launceston, Tasmania, Australia
| | - Paul Dawkins
- Department of Respiratory Medicine, Middlemore Hospital, Auckland, New Zealand
| | - Ross Lawrenson
- Waikato Medical Research Centre, University of Waikato, Hamilton, Waikato, New Zealand
- Strategy and Funding, Waikato District Health Board, Hamilton, New Zealand
| | - Mary Duffy
- Lung Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sue Evans
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Tracy Leong
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Henry Marshall
- Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Dainik Patel
- Department of Medical Oncology, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| | - Nick Pavlakis
- Medical Oncology, Genesis Care and University of Sydney, Sydney, New South Wales, Australia
| | - Jennifer Philip
- Department of Medicine, Univ Melbourne, Fitzroy, Victoria, Australia
| | - Nicole Rankin
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Nimit Singhal
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Emily Stone
- School of Clinical Medicine, University NSW, Sydney, Victoria, Australia
| | - Rebecca Tay
- Department of Medical Oncology, The Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Shalini Vinod
- Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Morgan Windsor
- Department of Thoracic Surgery, Prince Charles and Royal Brisbane Hospital, Brisbane, Queensland, Australia
| | - Gavin M Wright
- Department of Surgery, Cardiothoracic Surgery Unit, St Vincent, Victoria, Australia
| | - David Leong
- Department of Medical Oncology, John James Medical Centre Deakin, Canberra, Australian Capital Territory, Australia
| | - John Zalcberg
- Cancer Research Program, Monash University, Melbourne, Victoria, Australia
| | - Rob G Stirling
- Department of Medicine, Monash University, Clayton, Victoria, Australia
- Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| |
Collapse
|
6
|
Nartey Y, Tata LJ, Khakwani A, Beattie V, Beckett P, Hubbard RB, Stewart I. Using patient experiences to evaluate care and expectations in lung cancer: analysis of the English Cancer Patient Experience Survey linked with the national cancer registry. Support Care Cancer 2022; 30:4417-4428. [PMID: 35106657 PMCID: PMC8942895 DOI: 10.1007/s00520-022-06863-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/24/2022] [Indexed: 01/15/2023]
Abstract
Purpose Identification of unmet needs in person centred and supportive care could be limited by differences in experience across specific cancer populations. Using the experiences of people with lung cancer, we assess distinctions according to demographic and clinical characteristics. Methods The English Cancer Patient Experience Survey was linked to the national cancer registry. The primary outcome was experience of the lung cancer pathway when assessed in multi-question models developed with item response theory. Secondary outcomes were experience by treatment received and in separate dimensions of the care pathway: up to diagnosis, treatment information, and staff support. Results Responses from 15,967 adults with a lung cancer diagnosis between 2009 and 2015 were included. Positive experiences were more likely to be reported by people aged between 65 and 80 (adjusted coefficient 0.08, 95%CI 0.05;0.11), those living in the most deprived areas (adjusted coefficient 0.10, 95%CI 0.05;0.14), diagnosed at lung cancer stage IIA–B (adjusted coefficient 0.09, 95%CI 0.04;0.14), and those diagnosed through inpatient elective admissions (adjusted coefficient 0.17, 95%CI 0.07;0.28). Specific experiences differed across dimensions of care and within lung cancer treatment groups. Conclusions Experiences differed according to gender and ethnicity, supporting previous observations in cancer. In contrast to previous studies, people with lung cancer were more likely to report positive pathway experiences at older ages, living in more deprived areas, or diagnosed after stage I, all frequently associated with worse clinical outcomes. The distinct observations in lung cancer specific analyses suggest potential unmet needs, such as in early stage disease and younger age groups. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-06863-4.
Collapse
Affiliation(s)
- Yvonne Nartey
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Laila J Tata
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Aamir Khakwani
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Vanessa Beattie
- Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - Paul Beckett
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Richard B Hubbard
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Iain Stewart
- Division of Respiratory Medicine, NIHR Biomedical Research Centre, University of Nottingham, Nottingham, UK. .,National Heart & Lung Institute, Imperial College London, Guy Scadding Building, Cale Street, London, SW3 6LY, UK.
| |
Collapse
|
7
|
Snee M, Cheeseman S, Thompson M, Riaz M, Sopwith W, Lacoin L, Chaib C, Daumont MJ, Penrod JR, Hall G. Treatment patterns and survival outcomes for patients with non-small cell lung cancer in the UK in the preimmunology era: a REAL-Oncology database analysis from the I-O Optimise initiative. BMJ Open 2021; 11:e046396. [PMID: 34526333 PMCID: PMC8444261 DOI: 10.1136/bmjopen-2020-046396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 07/15/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To report characteristics, treatment and overall survival (OS) trends, by stage and pathology, of patients diagnosed with non-small cell lung cancer (NSCLC) at Leeds Teaching Hospital NHS Trust in 2007-2018. DESIGN Retrospective cohort study based on electronic medical records. SETTING Large NHS university hospital in Leeds. PARTICIPANTS 3739 adult patients diagnosed with incident NSCLC from January 2007 to August 2017, followed up until March 2018. MAIN OUTCOME MEASURES Patient characteristics at diagnosis, treatment patterns and OS. RESULTS 34.3% of patients with NSCLC were clinically diagnosed (without pathological confirmation). Among patients with known pathology, 45.2% had non-squamous cell carcinoma (NSQ) and 33.3% had squamous cell carcinoma (SQ). The proportion of patients diagnosed at stage I increased (16.4%-27.7% in 2010-2017); those diagnosed at stage IV decreased (57.0%-39.1%). Surgery was the most common initial treatment for patients with pathologically confirmed stage I NSCLC. Use of radiotherapy alone increased over time in patients with clinically diagnosed stage I NSCLC (39.1%-60.3%); chemoradiation increased in patients with stage IIIA NSQ (21.6%-33.3%) and SQ (24.2%-31.9%). Initial treatment with systemic anticancer therapy (SACT) increased in patients with stages IIIB-IV NSQ (49.0%-67.5%); the proportion of untreated patients decreased (30.6%-15.0%). Median OS improved for patients diagnosed with stage I NSQ and SQ and stage IIIA NSQ over time. Median OS for patients with stages IIIB-IV NSQ and SQ remained stable, <10% patients were alive 3 years after diagnosis. Median OS for clinically diagnosed stages IIIB-IV patients was 1.2 months in both periods. CONCLUSIONS OS for stage I and IIIA patients improved over time, likely due to increased use of stereotactic ablative radiation, surgery (stage I) and chemoradiation (stage IIIA). Conversely, OS outcomes remained poor for stage IIIB-IV patients despite increasing use of SACT for NSQ. Many patients with advanced-stage disease remained untreated.
Collapse
Affiliation(s)
- Michael Snee
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Sue Cheeseman
- REAL Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Majid Riaz
- REAL Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Will Sopwith
- REAL Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Carlos Chaib
- Research & Development Medical Affairs, Bristol Myers Squibb, Madrid, Spain
| | - Melinda J Daumont
- Worldwide Health Economics & Outcomes Research, Bristol Myers Squibb, Braine-l'Alleud, Belgium
| | - John R Penrod
- Worldwide Health Economics & Outcomes Research, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Geoff Hall
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| |
Collapse
|
8
|
The Dutch Lung Cancer Audit: Nationwide quality of care evaluation of lung cancer patients. Lung Cancer 2020; 149:68-77. [DOI: 10.1016/j.lungcan.2020.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 12/12/2022]
|
9
|
Stewart I, Leary A, Khakwani A, Borthwick D, Tod A, Hubbard R, Beckett P, Tata LJ. Do working practices of cancer nurse specialists improve clinical outcomes? Retrospective cohort analysis from the English National Lung Cancer Audit. Int J Nurs Stud 2020; 118:103718. [PMID: 32859375 DOI: 10.1016/j.ijnurstu.2020.103718] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cancer nurse specialists are advanced practitioners who offer continuity of care and expert support for people diagnosed with specific cancers. Health Education England's Cancer Workforce Plan prioritises expansion of cancer nurse specialist numbers by 2021 as part of the Cancer Taskforce Strategy for England. OBJECTIVE To assess whether working practices of advanced practice specialist nurses are associated with clinical outcomes for people with lung cancer. METHODS Adults with non-small cell lung cancer followed from 30 days post-diagnosis in English secondary care were obtained from the English National Lung Cancer Audit, 2007 to 2011. A national survey of lung cancer nurse specialists provided information on self-reported working practices. Mortality and unplanned admissions from 30 days to 12 months post diagnosis were respectively analysed using Cox and Poisson regression. Outcomes were assessed according to patients' receipt of initial assessments by a lung cancer nurse specialist and according to trust-level reported working practices. Regression models were adjusted for individual sociodemographic and clinical characteristics, error adjusted for intracorrelations within regional cancer networks, and presented separately according to patients' treatment pathways (surgery, chemotherapy, radiotherapy, or no anti-cancer therapy). RESULTS Data for 108,115 people with lung cancer were analysed and associations with mortality and unplanned admissions were infrequent. Among people receiving only radiotherapy, however, the hazard for death was 17% lower among those who received an assessment by a lung cancer nurse specialist, compared with no assessment (hazard ratio = 0.83, 95% confidence interval 0.73-0.94; p = 0.003). The hazard was also lower among those receiving surgery (hazard ratio = 0.91, 0.84-0.99; p = 0.028). Among those receiving radiotherapy, nurse specialists' reported confidence within multidisciplinary team settings was associated with a lower risk of death (hazard ratio = 0.88, 0.78-1.00; p = 0.049) and a lower rate of unplanned cancer-related admissions (incidence rate ratio = 0.83, 0.73-0.95; p = 0.007). Lung cancer nurse specialist assessments before/at diagnosis, were associated with a 5% lower rate of unplanned admissions, compared to when assessments occurred after diagnosis. CONCLUSION The contribution of nurse specialist working practices was occasionally associated with better outcomes for people with lung cancer. These were not limited to a single treatment pathway, but do indicate discrete relationships within pathways. Our study provides initial measures of overall lung cancer nurse specialist working practices at trusts, however, more detailed studies with longitudinal measurement of lung cancer nurse specialist-patient interaction are needed to better ascertain impacts on long-term patient outcomes. The findings highlight opportunities for potential improvement in effectiveness of service and care management.
Collapse
Affiliation(s)
- Iain Stewart
- Division of Epidemiology and Public Health, University of Nottingham, NG5 1PB, UK; NIHR Biomedical Research Centre, University of Nottingham, NG5 1PB, UK.
| | - Alison Leary
- London South Bank University, Division of Primary and Social Care, SE1 0AA, UK
| | - Aamir Khakwani
- Division of Epidemiology and Public Health, University of Nottingham, NG5 1PB, UK
| | - Diana Borthwick
- Western General Hospital, Edinburgh Cancer Centre, EH4 2JT, UK
| | - Angela Tod
- University of Sheffield, School of Nursing and Midwifery, S10 2LA, UK
| | - Richard Hubbard
- Division of Epidemiology and Public Health, University of Nottingham, NG5 1PB, UK
| | - Paul Beckett
- Derby Teaching Hospitals NHS Foundation Trust, DE22 3NE, UK
| | - Laila J Tata
- Division of Epidemiology and Public Health, University of Nottingham, NG5 1PB, UK
| |
Collapse
|
10
|
Li JX, Huang JM, Jiang ZB, Li RZ, Sun A, Lai-Han Leung E, Yan PY. Current Clinical Progress of PD-1/PD-L1 Immunotherapy and Potential Combination Treatment in Non-Small Cell Lung Cancer. Integr Cancer Ther 2020; 18:1534735419890020. [PMID: 31838881 PMCID: PMC7242804 DOI: 10.1177/1534735419890020] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Conventional methods in treating non–small cell lung cancer contain surgery,
chemotherapy, radiotherapy, and targeted therapy, which have various defects.
Recently, with the deeper research on tumor immunity, immunotherapy has made the
breakthrough in the treatment of cancers. Especially developments of programmed
cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors bring the
therapy into a new stage. This review mainly focuses on introducing existing
monoclonal antibodies containing nivolumab, pembrolizumab, atezolizumab,
avelumab, and durvalumab, along with 3 ordinary biomarkers such as PD-L1
expression, tumor mutation burden, and microsatellite instability. By
understanding the resistance mechanism of anti-PD-1/L1 blockade, research is
further improving the survival benefit and expanding the benefit population. So,
PD-1/PD-L1 inhibitors begin to be combined with various therapeutic strategies
clinically. Discussion and comparison of their effectiveness and safety are also
comprehensively reviewed. Meanwhile, we explore the potential, the impact, and
mechanisms of combining traditional Chinese medicine with immunotherapy.
Collapse
Affiliation(s)
- Jia-Xin Li
- Macau University of Science and Technology, Macau, People's Republic of China
| | - Ju-Min Huang
- Macau University of Science and Technology, Macau, People's Republic of China
| | - Ze-Bo Jiang
- Macau University of Science and Technology, Macau, People's Republic of China
| | - Run-Ze Li
- Macau University of Science and Technology, Macau, People's Republic of China
| | - Ao Sun
- Macau University of Science and Technology, Macau, People's Republic of China
| | - Elaine Lai-Han Leung
- Macau University of Science and Technology, Macau, People's Republic of China.,Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, People's Republic of China
| | - Pei-Yu Yan
- Macau University of Science and Technology, Macau, People's Republic of China
| |
Collapse
|
11
|
Leung M, Freidin MB, Freydina DV, Von Crease C, De Sousa P, Barbosa MT, Nicholson AG, Lim E. Blood-based circulating tumor DNA mutations as a diagnostic and prognostic biomarker for lung cancer. Cancer 2020; 126:1804-1809. [PMID: 31999831 DOI: 10.1002/cncr.32699] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/21/2019] [Accepted: 12/03/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The objectives of the current study were to develop an initial blood-based circulating tumor DNA (ctDNA) gene signature and to validate the clinical test performance in patients with early primary and secondary lung cancer. METHODS Between January 2009 and October 2014, a total of 211 patients with known or suspected lung cancer donated their blood prior to surgery and were followed up to May 2018. ctDNA was extracted from plasma and from corresponding formalin-fixed, paraffin-embedded tissues. The blood was analyzed in a blinded manner and pathology reports were issued that were blinded to the blood test results. The reference standard was histopathology confirmed cancer in the resected surgical specimens as reported according to World Health Organization criteria and staged using the eighth edition of the TNM Classification of Malignant Tumors criteria. RESULTS Of 211 consenting patients, 19 (9.0%) were excluded, leaving 192 participants, consisting of 95 men (49%) and with a mean age of 63 years (SD, 15 years). The clinical test performance for the blood-based diagnostic signature demonstrated a sensitivity of 75% (95% CI, 67%-81%), specificity of 89% (95% CI, 70%-98%), positive predictive value of 98% (95% CI, 93%-100%), and negative predictive value of 35% (95% CI, 24%-48%) when compared with conventional clinical histopathology reporting of the resected tissue. CONCLUSIONS The results of the current study suggested that blood-based ctDNA analysis of cancer mutations is a specific, noninvasive test for the diagnosis of cancer.
Collapse
Affiliation(s)
- Maria Leung
- Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom.,National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Maxim B Freidin
- Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom.,National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Daria V Freydina
- Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom.,National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Charlotte Von Crease
- Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom
| | - Paulo De Sousa
- Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom
| | - Monica T Barbosa
- Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom
| | - Andrew G Nicholson
- Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom.,National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Eric Lim
- Royal Brompton and Harefield National Health Service Foundation Trust, London, United Kingdom.,National Heart and Lung Institute, Imperial College London, London, United Kingdom
| |
Collapse
|
12
|
Khakwani A, Harden S, Beckett P, Baldwin D, Navani N, West D, Hubbard R. Post-treatment survival difference between lobectomy and stereotactic ablative radiotherapy in stage I non-small cell lung cancer in England. Thorax 2019; 75:237-243. [PMID: 31879316 DOI: 10.1136/thoraxjnl-2018-212493] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/04/2019] [Accepted: 10/09/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Approximately 15%-20% of all non-small cell lung cancer (NSCLC) cases present with stage I disease. Surgical resection traditionally offers the best chance of a cure but some patients will not have this treatment due to older age, comorbidities or personal choice. Stereotactic ablative radiotherapy (SABR) has become an established curative intent treatment option for patients who are not selected for or do not choose surgery. The aim of this study is to compare survival at 90 days, 6 months, 1 year and 2 years for patients who received either lobectomy or SABR. METHODS We used data from the 2015 National Lung Cancer Audit database and linked with Hospital Episode Statistics and the radiotherapy dataset to identify patients with NSCLC stage IA-IB and performance status (PS) 0-2 who underwent surgery or SABR treatment. We assessed the likelihood of death at 90 days, 6 months, 1 year and 2 year after diagnosis and procedure date to observe survival between two patient groups. RESULTS We identified 2373 patients in our cohort, 476 of whom had SABR. The median difference between date of diagnosis and date of treatment for surgery patients was 17 days while for SABR patients it was 73 days. Increasing age and worsening PS were associated with having SABR rather than surgery. Survival between the two treatment modalities was similar early on but by 1-year people who had surgery did better than those who had SABR (adjusted ORs 2.12, 95% CI 1.35 to 2.31). This difference persisted at 2 years and when the analysis was restricted to patients aged <80 years and with PS 0 or 1 and stage IA only. CONCLUSION Our analysis suggests that patients who have lobectomy have a better survival compared with SABR patients; however, we found considerable delays in patients receiving SABR which may contribute to poorer long-term outcomes with this treatment option. Reducing these delays should be a key focus in development and reorganisation of services.
Collapse
Affiliation(s)
- Aamir Khakwani
- Division of Epidemiology & Public Health, University of Nottingham, Nottingham, UK
| | - Susan Harden
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul Beckett
- Department of Respiratory Medicine, Derby Hospital NHS Foundation Trust, Derby, UK
| | - David Baldwin
- City Campus, Nottingham University Hospitals, Nottingham, UK
| | - Neal Navani
- Lungs for Living Research Centre, University College London Hospital, London, UK
| | - Doug West
- Thoracic Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Richard Hubbard
- Division of Epidemiology & Public Health, University of Nottingham, Nottingham, UK
| |
Collapse
|
13
|
Wu Q, Zhang B, Sun Y, Xu R, Hu X, Ren S, Ma Q, Chen C, Shu J, Qi F, He T, Wang W, Wang Z. Identification of novel biomarkers and candidate small molecule drugs in non-small-cell lung cancer by integrated microarray analysis. Onco Targets Ther 2019; 12:3545-3563. [PMID: 31190860 PMCID: PMC6526173 DOI: 10.2147/ott.s198621] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/21/2019] [Indexed: 12/23/2022] Open
Abstract
Background: Non-small-cell lung cancer (NSCLC) remains the leading cause of cancer morbidity and mortality worldwide. In the present study, we identified novel biomarkers associated with the pathogenesis of NSCLC aiming to provide new diagnostic and therapeutic approaches for NSCLC. Methods: The microarray datasets of GSE18842, GSE30219, GSE31210, GSE32863 and GSE40791 from Gene Expression Omnibus database were downloaded. The differential expressed genes (DEGs) between NSCLC and normal samples were identified by limma package. The construction of protein–protein interaction (PPI) network, module analysis and enrichment analysis were performed using bioinformatics tools. The expression and prognostic values of hub genes were validated by GEPIA database and real-time quantitative PCR. Based on these DEGs, the candidate small molecules for NSCLC were identified by the CMap database. Results: A total of 408 overlapping DEGs including 109 up-regulated and 296 down-regulated genes were identified; 300 nodes and 1283 interactions were obtained from the PPI network. The most significant biological process and pathway enrichment of DEGs were response to wounding and cell adhesion molecules, respectively. Six DEGs (PTTG1, TYMS, ECT2, COL1A1, SPP1 and CDCA5) which significantly up-regulated in NSCLC tissues, were selected as hub genes according to the results of module analysis. The GEPIA database further confirmed that patients with higher expression levels of these hub genes experienced a shorter overall survival. Additionally, CMap predicted the 20 most significant small molecules as potential therapeutic drugs for NSCLC. DL-thiorphan was the most promising small molecule to reverse the NSCLC gene expression. Conclusions: Based on the gene expression profiles of 696 NSCLC samples and 237 normal samples, we first revealed that PTTG1, TYMS, ECT2, COL1A1, SPP1 and CDCA5 could act as the promising novel diagnostic and therapeutic targets for NSCLC. Our work will contribute to clarifying the molecular mechanisms of NSCLC initiation and progression.
Collapse
Affiliation(s)
- Qiong Wu
- Medical School of Nantong University, Nantong 226001, People's Republic of China.,The Hand Surgery Research Center, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong 226001, People's Republic of China
| | - Bo Zhang
- Medical School of Nantong University, Nantong 226001, People's Republic of China.,The Hand Surgery Research Center, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong 226001, People's Republic of China
| | - Yidan Sun
- Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, People's Republic of China
| | - Ran Xu
- Medical School of Nantong University, Nantong 226001, People's Republic of China
| | - Xinyi Hu
- Department of Biochemistry & Molecular Biology, Nantong University, Nantong, Jiangsu 226001, People's Republic of China
| | - Shiqi Ren
- Department of Biochemistry & Molecular Biology, Nantong University, Nantong, Jiangsu 226001, People's Republic of China
| | - Qianqian Ma
- Emergency Office, Wuxi Center for Disease Control and Prevention, Wuxi 214023, People's Republic of China
| | - Chen Chen
- Department of Oncology, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Jian Shu
- The First People's Hospital of Taicang City, Taicang Affiliated Hospital of Soochow University, Suzhou 215400, People's Republic of China
| | - Fuwei Qi
- The First People's Hospital of Taicang City, Taicang Affiliated Hospital of Soochow University, Suzhou 215400, People's Republic of China
| | - Ting He
- The First People's Hospital of Taicang City, Taicang Affiliated Hospital of Soochow University, Suzhou 215400, People's Republic of China
| | - Wei Wang
- The Hand Surgery Research Center, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong 226001, People's Republic of China
| | - Ziheng Wang
- The Hand Surgery Research Center, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong 226001, People's Republic of China
| |
Collapse
|
14
|
Mileshkin L, Dunn C, Cross H, Duffy M, Shaw M, Antippa P, Mitchell P, Akhurst T, Conron M, Moore M, Philip J, Bartlett J, Emery J, Zambello B. The Victorian Comprehensive Cancer Centre lung cancer clinical audit: collecting the UK National Lung Cancer Audit data from hospitals in Australia. Intern Med J 2018; 49:1001-1006. [PMID: 30515932 DOI: 10.1111/imj.14183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/26/2018] [Accepted: 11/28/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clinical audit may improve practice in cancer service provision. The UK National Lung Cancer Audit (NLCA) collects data for all new cases of thoracic cancers. AIM To collect similar data for our Victorian patients from six hospitals within the Victorian Comprehensive Cancer Centre and associated Western and Central Melbourne Integrated Cancer Service. METHODS We conducted a retrospective audit of all newly diagnosed patients with lung cancer and mesothelioma in 2013 across the six Victorian Comprehensive Cancer Centre/Western and Central Melbourne Integrated Cancer Service hospitals. The objectives were to adapt the NLCA data set for use in the Australian context, to analyse the findings using descriptive statistics and to determine feasibility of implementing a routine, ongoing audit similar to that in the UK. Individual data items were adapted from the NLCA by an expert steering committee. Data were collated from the Victorian Cancer Registry, Victorian Admitted Episodes Dataset and individual hospital databases. Individual medical records were audited for missing data. RESULTS Eight hundred and forty-five patients were diagnosed across the sites in 2013. Most were aged 65-80 (55%) and were male (62%). Most had non-small-cell lung cancer (81%) with 9% diagnosed with small cell lung cancer and 2% with mesothelioma. Data completeness varied significantly between fields. For those with higher levels of completeness, headline indicators of clinical care were comparable with NLCA data. The Victorian population seem to lack access to specialist lung cancer nurse services. CONCLUSION Lung cancer care at participating hospitals appeared to be comparable with the UK in 2013. In future, prospective data collection should be harmonised across sites and correlated with survival outcomes. One area of concern was a lack of documented access to specialist nursing services.
Collapse
Affiliation(s)
- Linda Mileshkin
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Catherine Dunn
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Hannah Cross
- Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Mary Duffy
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Mark Shaw
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Phillip Antippa
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | | | - Tim Akhurst
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | - Melissa Moore
- St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Jenny Philip
- St Vincent's Hospital, Melbourne, Victoria, Australia
| | | | - Jon Emery
- General Practice and Primary Health Care Academic Centre, The University of Melbourne, Melbourne, Victoria, Australia
| | - Belinda Zambello
- Western and Central Melbourne Integrated Cancer Service, Melbourne, Victoria, Australia
| |
Collapse
|
15
|
Rich A, Beckett P, Baldwin D. Status of Lung Cancer Data Collection in Europe. JCO Clin Cancer Inform 2018; 2:1-12. [DOI: 10.1200/cci.17.00052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Anna Rich
- Anna Rich and David Baldwin, Nottingham University Hospitals National Health Service Trust, Nottingham, Nottinghamshire; and Paul Beckett, Royal Derby Hospital, Derby, Derbyshire, United Kingdom
| | - Paul Beckett
- Anna Rich and David Baldwin, Nottingham University Hospitals National Health Service Trust, Nottingham, Nottinghamshire; and Paul Beckett, Royal Derby Hospital, Derby, Derbyshire, United Kingdom
| | - David Baldwin
- Anna Rich and David Baldwin, Nottingham University Hospitals National Health Service Trust, Nottingham, Nottinghamshire; and Paul Beckett, Royal Derby Hospital, Derby, Derbyshire, United Kingdom
| |
Collapse
|
16
|
Rich A, Baldwin D, Alfageme I, Beckett P, Berghmans T, Brincat S, Burghuber O, Corlateanu A, Cufer T, Damhuis R, Danila E, Domagala-Kulawik J, Elia S, Gaga M, Goksel T, Grigoriu B, Hillerdal G, Huber RM, Jakobsen E, Jonsson S, Jovanovic D, Kavcova E, Konsoulova A, Laisaar T, Makitaro R, Mehic B, Milroy R, Moldvay J, Morgan R, Nanushi M, Paesmans M, Putora PM, Samarzija M, Scherpereel A, Schlesser M, Sculier JP, Skrickova J, Sotto-Mayor R, Strand TE, Van Schil P, Blum TG. Achieving Thoracic Oncology data collection in Europe: a precursor study in 35 Countries. BMC Cancer 2018; 18:1144. [PMID: 30458807 PMCID: PMC6247748 DOI: 10.1186/s12885-018-5009-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 10/29/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A minority of European countries have participated in international comparisons with high level data on lung cancer. However, the nature and extent of data collection across the continent is simply unknown, and without accurate data collection it is not possible to compare practice and set benchmarks to which lung cancer services can aspire. METHODS Using an established network of lung cancer specialists in 37 European countries, a survey was distributed in December 2014. The results relate to current practice in each country at the time, early 2015. The results were compiled and then verified with co-authors over the following months. RESULTS Thirty-five completed surveys were received which describe a range of current practice for lung cancer data collection. Thirty countries have data collection at the national level, but this is not so in Albania, Bosnia-Herzegovina, Italy, Spain and Switzerland. Data collection varied from paper records with no survival analysis, to well-established electronic databases with links to census data and survival analyses. CONCLUSION Using a network of committed clinicians, we have gathered validated comparative data reporting an observed difference in data collection mechanisms across Europe. We have identified the need to develop a well-designed dataset, whilst acknowledging what is feasible within each country, and aspiring to collect high quality data for clinical research.
Collapse
Affiliation(s)
- Anna Rich
- Department of Respiratory Medicine, Nottingham University Hospitals, City campus, Hucknall Road, Nottingham, NG5 1PB UK
| | - David Baldwin
- Department of Respiratory Medicine, Nottingham University Hospitals, City campus, Hucknall Road, Nottingham, NG5 1PB UK
| | | | - Paul Beckett
- Department of Respiratory Medicine, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK
| | - Thierry Berghmans
- Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Stephen Brincat
- Sir Anthony Mamo oncology centre, Mater Dei hospital, Msida, Malta
| | - Otto Burghuber
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Alexandru Corlateanu
- Department of Respiratory Medicine, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, Moldova
| | - Tanja Cufer
- University Clinic Golnik, Medical Faculty Ljubljana, Golnik, Slovenia
| | - Ronald Damhuis
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Edvardas Danila
- Clinic of Infectious and Chest Diseases, Dermatovenereology and Allergology, Vilnius University, Vilnius, Lithuania
- Centre of Pulmonology and Allergology, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania
| | | | - Stefano Elia
- Department of Thoracic Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Mina Gaga
- 7th Respiratory Medicine Department, Athens Chest Hospital, 152 Mesogion Ave Athens, 11527 Athens, Greece
| | - Tuncay Goksel
- Department of Pulmonary Medicine, School of Medicine, Ege University, Izmir, Turkey
| | - Bogdan Grigoriu
- Regional Institute of Oncology, University of Medicine and Pharmacy, Iasi, Romania
| | - Gunnar Hillerdal
- Department of Respiratory Diseases, Karolinska Hospital, Stockholm, Sweden
| | - Rudolf Maria Huber
- Division of Respiratory Medicine and Thoracic Oncology, University of Munich and Thoracic Oncology Centre, Munich, Germany
| | - Erik Jakobsen
- Department of Thoracic Surgery, Odense University Hospital, Odense, Denmark
| | - Steinn Jonsson
- Department of Medicine, Landspitali, University of Iceland, Reykjavik, Iceland
| | - Dragana Jovanovic
- University Hospital of Pulmonology, Clinical Center of Serbia, Belgrade, Serbia
| | - Elena Kavcova
- Clinic of Pneumology and Phthisiology, Comenius University Bratislava, Jessenius Faculty of Medicine Martin, University Hospital, Martin, Slovak Republic
| | - Assia Konsoulova
- Medical Oncology Department, University Hospital Sveta Marina, Varna, Bulgaria
| | - Tanel Laisaar
- Department of Thoracic Surgery, Tartu University Hospital, Tartu, Estonia
| | - Riitta Makitaro
- Department of Internal Medicine, Respiratory Research Unit, Medical Research Center Oulu, Oulu, Finland
- University Hospital and University of Oulu, POB 20, 90029 Oulu, Finland
| | - Bakir Mehic
- Clinic of Lung Diseases and TB, Sarajevo University Clinical Centre, Sarajevo, Bosnia and Herzegovina
| | - Robert Milroy
- Consultant Respiratory Physician & Chair, Scottish Lung Cancer Forum, Glasgow Royal Infirmary, Glasgow, Scotland
| | - Judit Moldvay
- Department of Tumor Biology, National Koranyi Institute, Semmelweis University, Budapest, Hungary
| | - Ross Morgan
- Department of Respiratory Medicine, Beaumont Hospital, Dublin, 9 Ireland
| | - Milda Nanushi
- University of Tirana, Service of Pulmonology, Tirana, Albania
| | - Marianne Paesmans
- Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Paul Martin Putora
- Department of Radiation Oncology, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland
| | - Miroslav Samarzija
- Department of Respiratory medicine, Klinički bolnički centar Zagreb, Zagreb, Croatia
| | - Arnaud Scherpereel
- Pulmonary and Thoracic Oncology, Univ. Lille, Inserm, CHU Lille, U1019 – CIIL, F-59000 Lille, France
| | - Marc Schlesser
- Respiratory Medicine Department, Centre Hospitalier Luxembourg, Luxembourg City, Luxembourg
| | - Jean-Paul Sculier
- Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Jana Skrickova
- Department Pulmonary Disease and TB, Masaryk University Faculty of Medicine & University Hospital, Brno, Czech Republic
| | - Renato Sotto-Mayor
- Pulmonology Service, Thoracic Department, North Lisbon Hospital Centre, Lisbon, Portugal
| | | | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Antwerp Belgium
| | - Torsten-Gerriet Blum
- Klinik für Pneumologie, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
| |
Collapse
|
17
|
Dreyer J, Bremer M, Henkenberens C. Comorbidity indexing for prediction of the clinical outcome after stereotactic body radiation therapy in non-small cell lung cancer. Radiat Oncol 2018; 13:213. [PMID: 30390700 PMCID: PMC6215615 DOI: 10.1186/s13014-018-1156-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 10/17/2018] [Indexed: 12/25/2022] Open
Abstract
Purpose To determine the prognostic impact of comorbidity and age in medically inoperable early-stage non-small cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT) using the age-adjusted Charlson Comorbidity Index (aCCI). Patients and methods Between November 2008 and January 2015, 196 consecutive patients with medically inoperable NSCLC were treated with SBRT at a single institution. The prescribed isocenter dose was either 60.0 Gray (Gy) in six fractions for central lung cancer or 56.25 Gy in three fractions for peripheral lung cancer. Baseline comorbidities were retrospectively retrieved according to available outclinic medical records as well as the hospital information system. The aCCI was scored for each patient and subjected according to outcome and toxicity as well as all of the single items of the aCCI and other clinical parameters using univariate and multivariate analysis. Results Thirty-one point 6 % (62/196) of patients were deceased, of whom 17.3% (34/196) died due to lung cancer and 14.3% (28/196) due to comorbidities. The median overall survival (OS) was 15.0 months (95% CI [11.9–18.1]), whereas the median cancer-specific survival (CSS) was not reached. An aCCI ≥7 compared with an aCCI ≤6 was significantly associated with an increased risk of death (HR 1.79, 95% CI [1.02–2.80], p = 0.04) and cancer-specific death (HR 9.26, 95% CI [4.83–24.39], p < 0.001), respectively. Neither OS nor CCS were significantly associated with age, sex, side (left vs. right), lobe, localization (central vs. peripheral), packyears, TNM, or any item of the aCCI. Considering the 14.3% (28/196) of deceased patients who died due to comorbidities, aCCI ≥9 was significantly associated with non-cancer-related death (HR 3.12, 95% CI [1.22–8.33], p = 0.02). The observed cumulative rate of radiation pneumonitis (RP) ≥2 was 12.7% (25/196). The aCCI had no statistical association with RP. Conclusion Advanced age and numerous comorbidities characterizing this patient population were successfully assessed using the aCCI in terms of survival. Therefore, we recommend that age and comorbidity be indexed using the aCCI as a simple scoring system for all patients treated with SBRT for lung cancer.
Collapse
Affiliation(s)
- Julia Dreyer
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Michael Bremer
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Christoph Henkenberens
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| |
Collapse
|
18
|
Li Z, Lu Q, Zhu D, Han Y, Zhou X, Ren T. Lnc-SNHG1 may promote the progression of non-small cell lung cancer by acting as a sponge of miR-497. Biochem Biophys Res Commun 2018; 506:632-640. [DOI: 10.1016/j.bbrc.2018.10.086] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 10/14/2018] [Indexed: 12/28/2022]
|
19
|
Hu XL, Xu ST, Wang XC, Hou DN, Chen CC, Song YL, Yang D. Prevalence of and risk factors for presenting initial respiratory symptoms in patients undergoing surgery for lung cancer. J Cancer 2018; 9:3515-3521. [PMID: 30310508 PMCID: PMC6171026 DOI: 10.7150/jca.26209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 07/22/2018] [Indexed: 12/25/2022] Open
Abstract
Background: Patients with early stage lung cancer seldom present initial respiratory symptoms, causing a delayed diagnosis and missed opportunity to receive operation. This study aimed to investigate the prevalence of initial respiratory symptoms and identity what factors would predispose lung cancer patients to present initial respiratory symptoms in patients undergoing lung cancer surgery. Methods: A retrospective chart review was conducted on 3,203 patients undergoing surgery for primary lung cancer. The prevalence of initial respiratory symptoms was investigated and the comparisons of clinicopathological parameters were performed between patients with and without initial respiratory symptoms or between patients with single and multiple initial respiratory symptoms. Independent risk factors for presenting initial respiratory symptoms or multiple initial respiratory symptoms were identified using a logistic regression. Results: A total of 1,474 (46.0%) patients with lung cancer were admitted to hospital due to present initial respiratory symptoms. Symptom clusters of cough or sputum (33.1%) and bloody sputum or hemoptysis (16.7%) presented as the two major chief complaints for medical consultation while chest pain (6.9%) and chest distress or dyspnea (5.6%) remained relatively unusual. Multiple analyses found that coexisting chronic obstructive pulmonary disease (OR=1.70, 95% CI=1.41-2.05), tumor size >3 cm (OR=2.27, 95% CI=1.93-2.67), squamous cell carcinoma (OR=2.22, 95% CI=1.86-2.65), tumor located in left lower lung (OR=1.39, 95% CI=1.10-1.74) and advanced tumor stage (OR=1.27, 95% CI=1.06-1.52) were independent risk factors for presenting initial respiratory symptoms. Furthermore, current smoking (OR=1.36, 95% CI=1.07-1.73), tumor size >3 cm (OR=1.53, 95% CI=1.21-1.93) and squamous cell carcinoma (OR=1.68, 95% CI=1.32-2.15) were demonstrated to be independent risk factors for presenting multiple initial respiratory symptoms. Conclusions: Presenting initial respiratory symptoms was the common cause for medical consultation in patients undergoing lung cancer surgery. Patients with lung cancer in larger tumor size or squamous cell carcinoma more likely presented initial and even multiple initial respiratory symptoms.
Collapse
Affiliation(s)
- Xiang-Lin Hu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Song-Tao Xu
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiao-Cen Wang
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dong-Ni Hou
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Cui-Cui Chen
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuan-Lin Song
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dong Yang
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
20
|
Chouaid C, Danson S, Andreas S, Siakpere O, Benjamin L, Ehness R, Dramard-Goasdoue MH, Barth J, Hoffmann H, Potter V, Barlesi F, Price M, Chirila C, Hollis K, Sweeney C, Wolowacz S, Kaye JA, Kontoudis I. Adjuvant treatment patterns and outcomes in patients with stage IB-IIIA non-small cell lung cancer in France, Germany, and the United Kingdom based on the LuCaBIS burden of illness study. Lung Cancer 2018; 124:310-316. [PMID: 30119925 DOI: 10.1016/j.lungcan.2018.07.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 07/27/2018] [Accepted: 07/30/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To inform health-technology assessments of new adjuvant treatments, we describe treatment patterns in patients with complete resection of stage IB-IIIA non-small cell lung cancer (NSCLC) in France, Germany, and the United Kingdom (UK). MATERIALS AND METHODS Data were collected via medical record abstraction. Patients were aged ≥18 years with completely resected stage IB-IIIA NSCLC, diagnosed between 01 January 2009 and 31 December 2011. Median follow-up was 26 months. Adjuvant treatment patterns and clinical outcomes were summarized descriptively. RESULTS Among the 831 patients studied, 239 (29%) had stage IB disease, 179 (22%) had stage IIA disease, 165 (20%) had stage IIB disease, and 248 (30%) had stage IIIA disease. Adjuvant systemic therapy was received by 402 patients (48.4%), (France, 61.8%; Germany, 51.9%; UK, 33.4%). Use of adjuvant therapy increased with increasing stage of disease. Cisplatin/vinorelbine and carboplatin/vinorelbine were the most frequently prescribed adjuvant regimens. Median disease-free survival was 48.0 months (95% confidence interval [CI] 42.3-not estimable); the 25th percentile was 13.2 months (95% CI, 11.0-15.3). 204 patients (24%) died during the follow-up period. The median overall survival was not reached, the 25th percentile was 31.2 months (95% CI 26.8-36.0 months). 272 patients (33%) had disease recurrence during the follow-up period. For 86 of those patients, the first recurrence was local or regional with no distant metastasis and 14 had further progression to metastatic disease during the follow-up time. For the other 186 patients, the first recurrence involved distant metastases. A total of 200 patients had metastatic disease at any time during study follow-up. CONCLUSIONS Less than half the patients with stage IB-IIIA NSCLC in this observational study received adjuvant systemic therapy. A high rate of first recurrence with distant metastatic disease was observed, emphasising the need for more effective systemic adjuvant therapies in this population.
Collapse
Affiliation(s)
| | - Sarah Danson
- Academic Unit of Clinical Oncology, Weston Park Hospital, Sheffield, S10 2SJ, United Kingdom.
| | - Stefan Andreas
- Lungenfachklinik Immenhausen, Krs. Kassel and Universitätsmedizin Göttingen, 37075 Göttingen, Robert Koch Str. 40, Germany.
| | | | | | | | | | | | - Hans Hoffmann
- Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
| | - Vanessa Potter
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
| | - Fabrice Barlesi
- Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Centre d'Investigation Clinique, 13385, Marseille, France.
| | - Mark Price
- RTI Health Solutions, Research Triangle Park, Durham, NC, United States.
| | - Costel Chirila
- RTI Health Solutions, Research Triangle Park, Durham, NC, United States.
| | - Kelly Hollis
- RTI Health Solutions, Research Triangle Park, Durham, NC, United States.
| | - Carolyn Sweeney
- RTI Health Solutions, Research Triangle Park, Durham, NC, United States.
| | - Sorrel Wolowacz
- Health Economics, RTI Health Solutions, The Pavilion, Towers Business Park, Wilmslow Road Manchester, M20 2LS, United Kingdom.
| | - James A Kaye
- Epidemiology, RTI Health Solutions, Waltham, MA, United States.
| | | |
Collapse
|
21
|
Polański J, Chabowski M, Jankowska-Polańska B, Janczak D, Rosińczuk J. Histological subtype of lung cancer affects acceptance of illness, severity of pain, and quality of life. J Pain Res 2018; 11:727-733. [PMID: 29692625 PMCID: PMC5903479 DOI: 10.2147/jpr.s155121] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction Histologic classification of lung cancer plays an important role in clinical practice. Two main histological subtype of lung cancer: small-cell lung cancer (SCLC) and nonsmall-cell lung cancer (NSCLC) differ in terms of invasiveness, response to treatment, and risk factors, among others. Aims To evaluate differences in acceptance of illness, level of perceived pain, and quality of life (QoL) between patients with SCLC and NSCLC. Materials and methods Two hundred and fifty-seven lung cancer patients, who were treated in 2015, completed Acceptance of Illness Scale, Visual Analog Scale for pain, and European Organization for Research and Treatment of Cancer 30-item Core Quality of Life Questionnaire and European Organization for Research and Treatment of Cancer 13-item Lung Cancer specific Quality of Life Questionnaire. Clinical and sociodemographic data were collected. For statistical analysis, the Student t-test and the Mann–Whitney U test were used. For comparisons among three or more groups, analysis of variance was employed. Results Patients with SCLC had significantly worse health as measured with the presence of metastases, parameters of lung function, comorbidities, and number of previous hospitalizations. The Acceptance of Illness Scale score and Visual Analog Scale score were significantly worse in patients with SCLC than in those with NSCLC (24.58±8.73 vs 27.05±9.06; p=0.046 and 4.81±2.01 vs 4.17±1.97; p=0.003). Patients with SCLC achieved worse scores of all aspects of QoL than patients with NSCLC. Comparison with the reference values showed that all dimensions of functioning are impaired in patients with lung cancer regardless of its type; only the role functioning in patients with NSCLC remains unaffected. Conclusion Monitoring of QoL, personalized approach to treatment, and interventions for symptom management should be conducted in a tailored manner. Socioeconomic status in lung cancer patients, especially those suffering from SCLC, needs to be addressed.
Collapse
Affiliation(s)
- Jacek Polański
- Lower Silesian Oncology Center, Home Hospice, Wroclaw, Poland
| | - Mariusz Chabowski
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.,Department of Surgery, 4th Military Teaching Hospital, Wroclaw, Poland
| | - Beata Jankowska-Polańska
- Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Dariusz Janczak
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.,Department of Surgery, 4th Military Teaching Hospital, Wroclaw, Poland
| | - Joanna Rosińczuk
- Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.,Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
22
|
Møller H, Coupland VH, Tataru D, Peake MD, Mellemgaard A, Round T, Baldwin DR, Callister MEJ, Jakobsen E, Vedsted P, Sullivan R, Spicer J. Geographical variations in the use of cancer treatments are associated with survival of lung cancer patients. Thorax 2018; 73:530-537. [PMID: 29511056 PMCID: PMC5969334 DOI: 10.1136/thoraxjnl-2017-210710] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/30/2017] [Accepted: 12/04/2017] [Indexed: 12/25/2022]
Abstract
Introduction Lung cancer outcomes in England are inferior to comparable countries. Patient or disease characteristics, healthcare-seeking behaviour, diagnostic pathways, and oncology service provision may contribute. We aimed to quantify associations between geographic variations in treatment and survival of patients in England. Methods We retrieved detailed cancer registration data to analyse the variation in survival of 176,225 lung cancer patients, diagnosed 2010-2014. We used Kaplan-Meier analysis and Cox proportional hazards regression to investigate survival in the two-year period following diagnosis. Results Survival improved over the period studied. The use of active treatment varied between geographical areas, with inter-quintile ranges of 9%–17% for surgical resection, 4%–13% for radical radiotherapy, and 22%–35% for chemotherapy. At 2 years, there were 188 potentially avoidable deaths annually for surgical resection, and 373 for radical radiotherapy, if all treated proportions were the same as in the highest quintiles. At the 6 month time-point, 318 deaths per year could be postponed if chemotherapy use for all patients was as in the highest quintile. The results were robust to statistical adjustments for age, sex, socio-economic status, performance status and co-morbidity. Conclusion The extent of use of different treatment modalities varies between geographical areas in England. These variations are not attributable to measurable patient and tumour characteristics, and more likely reflect differences in clinical management between local multi-disciplinary teams. The data suggest improvement over time, but there is potential for further survival gains if the use of active treatments in all areas could be increased towards the highest current regional rates.
Collapse
Affiliation(s)
- Henrik Møller
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.,Department of Public Health, Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Victoria H Coupland
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Daniela Tataru
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Michael D Peake
- National Cancer Registration and Analysis Service, Public Health England, London, UK.,Department of Respiratory Medicine, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Anders Mellemgaard
- Department of Oncology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Thomas Round
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - David R Baldwin
- Division of Respiratory Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK
| | | | - Erik Jakobsen
- Department of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark
| | - Peter Vedsted
- Department of Public Health, Research Centre for Cancer Diagnosis in Primary Care (CaP), Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Richard Sullivan
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - James Spicer
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| |
Collapse
|
23
|
da Silva GT, Bergmann A, Thuler LCS. Impact of Symptomatic Metastatic Spinal Cord Compression on Survival of Patients with Non-Small-Cell Lung Cancer. World Neurosurg 2017; 108:698-704. [DOI: 10.1016/j.wneu.2017.09.079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 01/05/2023]
|
24
|
Baldwin DR. Socioeconomic position and delays in lung cancer diagnosis: should we target the more deprived? Thorax 2016; 72:393-395. [PMID: 27993958 DOI: 10.1136/thoraxjnl-2016-209591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
25
|
Surgery and Surgical Consult Rates for Early Stage Lung Cancer in Ontario: A Population-Based Study. Ann Thorac Surg 2016; 103:906-910. [PMID: 27939011 DOI: 10.1016/j.athoracsur.2016.09.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 09/05/2016] [Accepted: 09/07/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Surgery offers the best chance for survival for early (stage I and II) non-small cell lung cancer (NSCLC), but worldwide resection rates range from 49% to 77%. We investigated factors that may play a role in resection rates. METHODS Using administrative data, new diagnoses of NSCLC from 2010 through 2012 were captured. The rate of surgical consultation and resection overall and by age group were determined, as well as rates of pulmonary function testing and radiation therapy. RESULTS Of 4,309 persons diagnosed with stage I or II NSCLC between 2010 and 2012, 3,487 (80.9%) received surgical consultations, but only 58.9% (2,539) received surgery. Rates of consultation and surgery decreased with increasing patient age: only 60.3% of patients older than 80 received consultations and 29.9% had resections. Of the 1,770 patients who did not receive surgery, 948 (53.6%) received a surgical consultation, and in this group, 688 (72.5%) were treated with radiation. Of the 822 patients who did not see a surgeon, only 476 (57.9%) were treated with radiation. Pulmonary function testing was performed in 799 (84.3%) of patients who had surgical consults but in only 569 (69.2%) of those who did not see a surgeon. CONCLUSIONS Resection rates for early lung cancer appear low, which may be partly due to low rates of surgical consultation. Interestingly, patients who are seen by surgeons but who do not receive surgery are more likely to receive radiation than patients who are not referred for surgery. Further research is required to identify factors influencing resection rates.
Collapse
|
26
|
Murage P, Crawford SM, Bachmann M, Jones A. Geographical disparities in access to cancer management and treatment services in England. Health Place 2016; 42:11-18. [PMID: 27614062 DOI: 10.1016/j.healthplace.2016.08.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 08/01/2016] [Accepted: 08/25/2016] [Indexed: 11/19/2022]
Abstract
This study seeks to examine the extent to which cancer services are geographically located according to cancer incidence, and assess the association with cancer survival. We identified hospital sites serving English PCTs (Primary Care Trusts) with the management and treatment of breast, lung and colorectal cancer. Geographical access was estimated as travel time in minutes from LSOAs (Lower Super Output Areas) to the nearest hospital site and aggregated to PCT level. Correlations between PCT level mean travel times and cancer cases were estimated using Spearman's rank correlation. Associations between PCT level mean travel times and cancer relative survival rates were estimated using linear regression with adjustment for area deprivation and for a PCT level measure of the reported ease of obtaining a doctor's appointment. We found that cancer services tended to be located farther from areas with more cancer cases, and longer average travel times are associated with worse survival after adjustment for age, sex, year and area deprivation. This suggests that geographical access to cancer services remains a concern in England.
Collapse
Affiliation(s)
| | | | - Max Bachmann
- Norwich Medical School, University of East Anglia, UK
| | - Andy Jones
- Norwich Medical School, University of East Anglia, UK
| |
Collapse
|
27
|
Hsu YL, Hung JY, Liang YY, Lin YS, Tsai MJ, Chou SH, Lu CY, Kuo PL. S100P interacts with integrin α7 and increases cancer cell migration and invasion in lung cancer. Oncotarget 2016; 6:29585-98. [PMID: 26320193 PMCID: PMC4745748 DOI: 10.18632/oncotarget.4987] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 07/16/2015] [Indexed: 01/11/2023] Open
Abstract
S100P, a Ca2+ binding protein, has been shown to be overexpressed in various cancers. However, its functional character in lung cancer remains largely unknown. In this study, we show that S100P increases cancer migration, invasion and metastasis in lung cancer cells. Ectopic expression of S100P increases migration, invasion and EMT in less invasive CL1-0 lung cancer cells. Conversely, knockdown of S100P suppressed migration and invasion, and caused a reversion of EMT in highly invasive lung cancer cells. These effects were transduced by increasing the interaction of S100P with integrin α7, which activated focal adhesion kinase (FAK) and AKT. Blocking FAK significantly decreased S100P-induced migration by decreasing Src and AKT activation, whereas inhibiting AKT reduced S100P upregulation on ZEB1 expression. Further study has indicated that S100P knockdown prevents the spread of highly metastatic human lung cancer in animal models. This study therefore suggests that S100P represents a critical activator of lung cancer metastasis. Detection and targeted treatment of S100P-expressing cancer is an attractive therapeutic strategy in treating lung cancer.
Collapse
Affiliation(s)
- Ya-Ling Hsu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jen-Yu Hung
- Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Yu Liang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Shiuan Lin
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Ju Tsai
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shah-Hwa Chou
- Division of Chest Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chi-Yu Lu
- Department of Biochemistry, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Lin Kuo
- Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan
| |
Collapse
|
28
|
Møller H, Riaz SP, Holmberg L, Jakobsen E, Lagergren J, Page R, Peake MD, Pearce N, Purushotham A, Sullivan R, Vedsted P, Luchtenborg M. High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England. Eur J Cancer 2016; 64:32-43. [PMID: 27328450 DOI: 10.1016/j.ejca.2016.05.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 12/14/2022]
Abstract
It is debated whether treating cancer patients in high-volume surgical centres can lead to improvement in outcomes, such as shorter length of hospital stay, decreased frequency and severity of post-operative complications, decreased re-admission, and decreased mortality. The dataset for this analysis was based on cancer registration and hospital discharge data and comprised information on 15,738 non-small-cell lung cancer patients resident and diagnosed in England in 2006-2010 and treated by surgical resection. The number of lung cancer resections was computed for each hospital in each calendar year, and patients were assigned to a hospital volume quintile on the basis of the volume of their hospital. Hospitals with large lung cancer surgical resection volumes were less restrictive in their selection of patients for surgical management and provided a higher resection rate to their geographical population. Higher volume hospitals had shorter length of stay and the odds of re-admission were 15% lower in the highest hospital volume quintile compared with the lowest quintile. Mortality risks were 1% after 30 d and 3% after 90 d. Patients from hospitals in the highest volume quintile had about half the odds of death within 30 d than patients from the lowest quintile. Variations in outcomes were generally small, but in the same direction, with consistently better outcomes in the larger hospitals. This gives support to the ongoing trend towards centralisation of clinical services, but service re-organisation needs to take account of not only the size of hospitals but also referral routes and patient access.
Collapse
Affiliation(s)
- Henrik Møller
- King's College London, Cancer Epidemiology, Population and Global Health, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK; Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK; Public Health England, UK National Cancer Analysis and Registration Service, 2nd Floor Skipton House, 80 London Road, London SE1 6LH, UK; Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark.
| | - Sharma P Riaz
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK.
| | - Lars Holmberg
- King's College London, Cancer Epidemiology, Population and Global Health, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK.
| | - Erik Jakobsen
- The Danish Lung Cancer Registry, Department of Thoracic Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark.
| | - Jesper Lagergren
- King's College London, Cancer Epidemiology, Population and Global Health, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK; Department of Molecular Medicine and Surgery (MMK), K1, Upper Gastrointestinal Research, Övre gastrointestinal forskning, NS 67, Institutionen för molekylär medicin och kirurgi, Karolinska Institutet, 171 76 Stockholm, Sweden.
| | - Richard Page
- Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK.
| | - Michael D Peake
- Public Health England, UK National Cancer Analysis and Registration Service, 2nd Floor Skipton House, 80 London Road, London SE1 6LH, UK.
| | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
| | - Arnie Purushotham
- King's College London, Cancer Epidemiology, Population and Global Health, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK.
| | - Richard Sullivan
- King's College London, Cancer Epidemiology, Population and Global Health, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK.
| | - Peter Vedsted
- Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark.
| | - Margreet Luchtenborg
- King's College London, Cancer Epidemiology, Population and Global Health, Research Oncology, 3rd Floor Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK; Public Health England, UK National Cancer Analysis and Registration Service, 2nd Floor Skipton House, 80 London Road, London SE1 6LH, UK.
| |
Collapse
|
29
|
Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across england. Lung Cancer 2016; 96:33-40. [DOI: 10.1016/j.lungcan.2016.03.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/10/2016] [Accepted: 03/25/2016] [Indexed: 11/23/2022]
|
30
|
Walters S, Benitez-Majano S, Muller P, Coleman MP, Allemani C, Butler J, Peake M, Guren MG, Glimelius B, Bergström S, Påhlman L, Rachet B. Is England closing the international gap in cancer survival? Br J Cancer 2015; 113:848-60. [PMID: 26241817 PMCID: PMC4559829 DOI: 10.1038/bjc.2015.265] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 06/19/2015] [Accepted: 06/24/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We provide an up-to-date international comparison of cancer survival, assessing whether England is 'closing the gap' compared with other high-income countries. METHODS Net survival was estimated using national, population-based, cancer registrations for 1.9 million patients diagnosed with a cancer of the stomach, colon, rectum, lung, breast (women) or ovary in England during 1995-2012. Trends during 1995-2009 were compared with estimates for Australia, Canada, Denmark, Norway and Sweden. Clinicians were interviewed to help interpret trends. RESULTS Survival from all cancers remained lower in England than in Australia, Canada, Norway and Sweden by 2005-2009. For some cancers, survival improved more in England than in other countries between 1995-1999 and 2005-2009; for example, 1-year survival from stomach, rectal, lung, breast and ovarian cancers improved more than in Australia and Canada. There has been acceleration in lung cancer survival improvement in England recently, with average annual improvement in 1-year survival rising to 2% during 2010-2012. Survival improved more in Denmark than in England for rectal and lung cancers between 1995-1999 and 2005-2009. CONCLUSIONS Survival has increased in England since the mid-1990s in the context of strategic reform in cancer control, however, survival remains lower than in comparable developed countries and continued investment is needed to close the international survival gap.
Collapse
Affiliation(s)
- Sarah Walters
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Sara Benitez-Majano
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Patrick Muller
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - John Butler
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
- Department of Gynaecological Oncology, Royal Marsden Hospital, London SW3 6JJ, UK
| | - Mick Peake
- Glenfield Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, UK
| | - Marianne Grønlie Guren
- Department of Oncology, Oslo University Hospital, Ullevaal, PO Box 4956, Nydalen, NO-0424 Oslo, Norway
- K. G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, PO Box 4953, Nydalen, NO-0424 Oslo, Norway
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
| | | | - Lars Påhlman
- Department of Surgical Sciences, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden
| | - Bernard Rachet
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| |
Collapse
|
31
|
Leduc C, Quoix E. Systemic treatment of elderly patients. Lung Cancer 2015. [DOI: 10.1183/2312508x.10010614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
32
|
Assaad S, Kyriakides T, Tellides G, Kim AW, Perkal M, Perrino A. Extravascular Lung Water and Tissue Perfusion Biomarkers After Lung Resection Surgery Under a Normovolemic Fluid Protocol. J Cardiothorac Vasc Anesth 2015; 29:977-83. [DOI: 10.1053/j.jvca.2014.12.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Indexed: 11/11/2022]
|
33
|
Evison M, Crosbie P, Morris J, Martin J, Shah R, Doran H, Hoyle J, Bailey S, Rana D, Sundar R, Booton R. Referral patterns for mediastinal staging with EBUS across a UK Lung Cancer Network: A report from the Manchester Cancer EBUS sub-group. Lung Cancer 2015; 88:114-5. [PMID: 25703892 DOI: 10.1016/j.lungcan.2015.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 02/01/2015] [Indexed: 10/24/2022]
Affiliation(s)
- Matthew Evison
- North West Lung Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester M23 9LT, UK; The Institute of Inflammation and Repair, The University of Manchester, Manchester, UK.
| | - Philip Crosbie
- North West Lung Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester M23 9LT, UK; The Institute of Inflammation and Repair, The University of Manchester, Manchester, UK
| | - Julie Morris
- Department of Medical Statistics, University Hospital South Manchester, Southmoor Road, Manchester M23 9LT, UK
| | - Julie Martin
- North West Lung Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester M23 9LT, UK
| | - Rajesh Shah
- Thoracic Surgery, University Hospital South Manchester, Southmoor Road, Manchester M23 9LT, UK
| | - Helen Doran
- Department of Pathology, University Hospital South Manchester, Southmoor Road, Manchester M23 9LT, UK
| | - Jennifer Hoyle
- Department of Respiratory Medicine, North Manchester General Hospital, Pennine Acute NHS Trusts, Delaunays Road, Manchester M8 5RB, UK
| | - Simon Bailey
- Department of Respiratory Medicine, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
| | - Durgesh Rana
- Department of Pathology, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
| | - Ram Sundar
- Department of Respiratory Medicine, Royal Albert Edward Hospital, Wrightington Wigan and Leigh NHS Foundation Trust, Wigan Lane, Wigan WN1 2NN, UK
| | - Richard Booton
- North West Lung Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester M23 9LT, UK; The Institute of Inflammation and Repair, The University of Manchester, Manchester, UK
| |
Collapse
|
34
|
McPhail S, Johnson S, Greenberg D, Peake M, Rous B. Stage at diagnosis and early mortality from cancer in England. Br J Cancer 2015; 112 Suppl 1:S108-15. [PMID: 25734389 PMCID: PMC4385983 DOI: 10.1038/bjc.2015.49] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: Stage at diagnosis is a key predictor of overall cancer outcome. For the first time, stage completeness is high enough for robust analysis for the whole of England. Methods: We analysed data from the National Cancer Registration Service's (NCRS) Cancer Analysis System on persons diagnosed with breast, colorectal, lung, prostate or ovarian cancers in England in 2012. One-year relative survival (followed-up to the end of 2013) was calculated along with adjusted excess rate ratios, for mortality within 1 year. Results: One-year relative survival decreased with increasing stage at diagnosis. For breast, prostate and colorectal cancers survival showed a major reduction for stage 4 cancers, whereas for lung and ovarian cancers there were substantial decreases in relative survival for each level of increase in stage. Excess rate ratios for mortality within 1 year of diagnosis showed that stage and age were the most important cofactors, but they also identified the statistically significant effects of sex, income deprivation and geographic area of residence. Conclusions: Further reductions in mortality may be most effectively achieved by diagnosing all cancers before they progress to stage 4, but for lung and ovarian cancers there is also a need for a stage shift to earlier stages together with efforts to improve stage-specific survival at all stages.
Collapse
Affiliation(s)
- S McPhail
- National Cancer Intelligence Network (NCIN), Public Health England, 5th Floor, Wellington House, 135-155 Waterloo Road, London SE1 8UG, UK
| | - S Johnson
- National Cancer Intelligence Network (NCIN), Public Health England, 5th Floor, Wellington House, 135-155 Waterloo Road, London SE1 8UG, UK
| | - D Greenberg
- National Cancer Registration Service (NCRS), Public Health England, Unit C, Magog Court, Shelford Bottom, Hinton Way, Cambridge CB22 3AD, UK
| | - M Peake
- National Cancer Intelligence Network (NCIN), Public Health England, 5th Floor, Wellington House, 135-155 Waterloo Road, London SE1 8UG, UK
| | - B Rous
- National Cancer Registration Service (NCRS), Public Health England, Unit C, Magog Court, Shelford Bottom, Hinton Way, Cambridge CB22 3AD, UK
| |
Collapse
|
35
|
Khakwani A, Rich AL, Powell HA, Tata LJ, Stanley RA, Baldwin DR, Duffy JP, Hubbard RB. The impact of the ‘hub and spoke’ model of care for lung cancer and equitable access to surgery. Thorax 2014; 70:146-51. [DOI: 10.1136/thoraxjnl-2014-205841] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
36
|
Mokhles S, Nuyttens JJ, Maat APWM, Birim Ö, Aerts JGJV, Bogers AJJC, Takkenberg JJM. Survival and Treatment of Non-small Cell Lung Cancer Stage I–II Treated Surgically or with Stereotactic Body Radiotherapy: Patient and Tumor-Specific Factors Affect the Prognosis. Ann Surg Oncol 2014; 22:316-23. [DOI: 10.1245/s10434-014-3860-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Indexed: 11/18/2022]
|
37
|
A multicentre randomised controlled trial of reciprocal lung cancer peer review and supported quality improvement: results from the improving lung cancer outcomes project. Br J Cancer 2014; 110:1936-42. [PMID: 24651386 PMCID: PMC3992504 DOI: 10.1038/bjc.2014.146] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/11/2014] [Accepted: 02/24/2014] [Indexed: 12/03/2022] Open
Abstract
Background: Results from the National Lung Cancer Audit demonstrate unexplained variation in outcomes. Peer review with supported quality improvement has been shown to reduce variation in other areas of health care but has not been formally tested in cancer multidisciplinary teams. The aim of the current study is to assess the impact of reciprocal peer-to-peer review visits with supported quality improvement and collaborative working on lung cancer process and outcome measures. Methods: English lung cancer teams were randomised to usual care or facilitated reciprocal peer review visits followed by 12 months of supported quality improvement. The primary outcome was change in the following national audit indicators; mulitdisciplinary team discussion, histological confirmation, active treatment, surgical resection, small-cell chemotherapy and specialist nurse review. Patient experience was measured using a new lung cancer patient questionnaire in the intervention group. Results: Thirty teams (31 trusts) entered the intervention group and 29 of these submitted a total of 67 quality improvement plans. Active treatment increased in the intervention group (n=31) by 5.2% compared with 1.2% in the control group (n=48, mean difference 4.1%, 95% CI −0.1 to 8.2%, P=0.055). The remaining audit indicators improved similarly in all groups. Mean patient experience scores in the intervention group did not change significantly during the study but a significant improvement was seen in the scores for the five teams with the worst baseline scores (0.86 to 0.22, P<0.001). Conclusions: Reciprocal peer review with supported quality improvement was feasible and effective in stimulating quality improvement activity but resulted in only modest improvements in lung cancer treatment rates and patient experience.
Collapse
|
38
|
Thapa B, Sayami P. Low Lung Cancer Resection Rates in a Tertiary Level Thoracic Center in Nepal - Where Lies Our Problem? Asian Pac J Cancer Prev 2014; 15:175-8. [DOI: 10.7314/apjcp.2014.15.1.175] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|