Author of

• 10720

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  P1.09 - Poster Session 1 - Combined Modality (ID 212)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Combined Modality
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10740

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    P1.09-020 - Clinical guideline adherence in locally advanced non-small cell lung cancer: A south western Sydney perspective (ID 3171)

    09:30 - 09:30  |  Author(s): K.J. Duggan
    • Abstract

    Background
    Stage III non-small cell lung cancer (NSCLC) typically represents up to one third of all new NSCLC diagnoses, and can be a technically difficult and controversial group of patients to definitively manage. In 2004, the National Health and Medical Research Council published a set of evidence based clinical guidelines for the management of lung cancer in Australia. This study aims to investigate adherence to these national guidelines in the treatment of Stage III cancers and identify factors associated with the receipt of guideline recommended therapy (GRT) and patient survival.

    Methods
    A retrospective cohort of newly diagnosed, Stage III NSCLC was identified from the South Western Sydney (SWS) Local Health District Clinical Cancer Registry. Cases were diagnosed between 2006 and 2011 and resided within SWS local postcode boundaries. Pre-2010 diagnosed “wet” stage IIIB cases with malignant pleural effusion were excluded from analysis. GRT was assigned to each case based on stage group and performance status (ECOG) at diagnosis. Significant factors associated with adherence to GRT and the effect these factors had on patient survival was determined using univariate analysis and Cox proportional hazards regression model.

    Results
    Of 316 eligible cases identified, 19 patients (6%) had no ECOG documentation found, and were excluded from the analysis. Median age of the remaining cohort was 69 years, and 64% were male. Disease stage distribution was 58% for IIIA cases and 42% for IIIB. 85% of patients were identified as having Good ECOG (0-2) at diagnosis. Overall 55% of the total; 63% of IIIA and 46% of IIIB patients received GRT. 24% of IIIA patients received surgery alone in combination with chemotherapy and/or radiotherapy. 31% of IIIB patients received either concurrent or combination chemo-radiation. On univariate analysis, the receipt of GRT was associated with patient age (p <0.001), disease stage (p 0.003), and performance status (p <0.001). Morphological subtype was trending (p 0.056). Overall median survival was 11.4 months. Patient survival was not significantly improved with the receipt of GRT.

    Conclusion
    Adherence to GRT was associated with tumour stage, patient age and performance status. In this cohort of patients, the receipt of GRT did not have a significant impact on survival.