Early NSCLC: academic/research programs offer best chance at survival

  • Wang S & al.
  • Cancer
  • 10 Sep 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Academic/research programs (ARPs) reported the best survival and surgery rates for early-stage NSCLC, whereas community cancer programs (CCPs) offered the worse survival and lowest surgery rates.

Why this matters

  • Previous studies that examined NSCLC outcomes based on hospital volume and type have yielded conflicting results.

Study design

  • 332,175 patients with stage I-II NSCLC treated at 1299 facilities from the National Cancer Database.
  • Funding: NIH; others.

Key results

  • Surgery rate was highest at ARPs, at 74.8%, followed by integrated network cancer program (INCPs) at 69.8%, comprehensive CCPs at 68.4%, and CCPs at 60.8% (P<.001>
  • ARPs had the best median OS at 59.1 months, followed by INCPs at 49.9 months, comprehensive CCPs at 46.3 months, and CCPs at 36.0 months (P<.001>
  • Compared with CCPs, ARP facilities were most likely to treat NSCLC with surgery (aOR, 1.81), followed by INCPs (aOR, 1.44) and comprehensive CCPs (aOR, 1.36; P<.001 for all>
  • Higher patient volume was associated with a higher likelihood of performing surgery in ARPs (aOR, 1.31), comprehensive CCPs (aOR, 1.12), and CCPs (aOR, 1.46; P<.001 for all>
  • Propensity matching produced similar results.

Limitations

  • No data on treatment costs.