Lung cancer patterns of care and outcomes — ASN Events
  1. Schedule
  2. ASCO/IPOS/COSA Symposium - Optimising outcomes after lung cancer – Targets and strategies (Part A)
  3. Lung cancer patterns of care and outcomes

Lung cancer patterns of care and outcomes (#258)

Dianne O'Connell 1 2 3 4
  1. Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
  2. Sydney Medical School - Public Health, University of Sydney, Sydney, NSW, Australi
  3. School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
  4. School of Public Health and Community Medicine, University of Newcastle, Newcastle, NSW, Australia

Objectives

The aims were to describe:

1.            How people with lung cancer are managed in New South Wales (NSW)

2.            Whether lung cancer treatment was in accordance with evidence-based guidelines

3.            Differences in survival for lung cancer patients receiving different types of treatment

Methods

Data on treatment were obtained from treating clinicians and medical records for 1290 patients with non-small cell lung cancer (NSCLC) identified in the population-based NSW Central Cancer Registry. Based on the recommendations in the Australian clinical practice guidelines for lung cancer, patients’ treatments were categorised as optimal, non-optimal or no treatment received.

Results

One in three patients did not receive surgery, chemotherapy or radiotherapy as initial treatment. Not receiving treatment for NSCLC was associated with: being female, older age, living outside a metropolitan area, having metastatic or unknown stage disease, poorer performance status, weight loss or not seen by a lung cancer specialist or seen only by a low volume lung cancer specialist.

The percentages of patients with good performance status who received the guideline recommended optimal treatment were 57% for Stage I/II, 32% for Stage IIIA, 13% for Stage IIIB and 22% for Stage IV disease.

After adjusting for clinical and health service factors, survival was significantly higher for patients with Stage III or IV disease who received the optimal treatment compared with those who did not receive the optimal treatment (hazard ratio 0.43, 95% confidence interval 0.27-0.69 for Stage III; 0.69, 0.52-0.91 for Stage IV). There was no significant difference in survival after two years for Stage I/II patients.

Discussion

The management of NSCLC varies with patient’s prognostic factors, place of residence and treating clinician’s experience. Patients who received the recommended optimal treatment had better survival after adjusting for important prognostic factors including stratification by stage.