Author of

• 11595

  +

  P2.07 - Poster Session 2 - Surgery (ID 190)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11613

    +

    P2.07-018 - Curative Surgery In Lung Cancer: Cases Presented At Multidisciplinary Meetings Compared With A Contemporaneous Control Group. (ID 1713)

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

    Background
    Multidisciplinary team (MDT) meetings have developed to enhance disease-specific interdisciplinary communication towards accelerating the initiation of appropriate therapy and improving both patient care and survival. They have long been a mainstay in the management of patients with cancer. This study aims to compare resection rates, surgical cure (based on post-resection pathological status) and co-morbidity status in consecutive lung cancer cases (stages IA-IIB, IASLC TNM staging 6[th] or 7[th] ed.), as presented at our institution’s Lung Cancer MDT meeting, compared with a similar contemporaneous control group not presented at the MDT meeting.

    Methods
    Data for this study was drawn from the Clinical Cancer Registry Project (ClinCR) database in NSW, which captures all cases of lung cancer managed in the public health system as well as databases used by the Lung Cancer MDT and Cardiothoracic Surgery. Cases of non-small cell lung cancer (NSCLC) appropriate for curative surgery based on pre-operative stage IA-IIB were analysed for MDT presentation, resection rate, surgical cure rate and for pre-operative Charlson co-morbidity score.

    Results
    Data were analysed from the time period 2006-2011. During this time 755 cases of NSCLC were diagnosed, 377 were presented at MDT (49.9%) and 378 were not (50.1%). A total of 138 cases of early stage disease (stages IA-IIB) were identified, 90 of which were presented at MDT (65.2%) and 48 were not (34.8%). Significantly more cases of early stage disease presented at MDT, 33/90 (36.7%) had resection than cases of early stage disease not presented at MDT 13/48 (27.1%) (p=0.015). Overall resection rate in early stage disease (MDT and non-MDT) was 46/138 (33.3%). In resected cases the surgical cure rate (according to surgical margins) did not differ significantly between the two groups with 30/33 (90.9%) in the MDT group and 12/13 (92.3%) in the non-MDT group achieving surgical cure (p=0.75). For cases of early stage NSCLC presented at MDT the odds ratio for surgical resection was 2.5. Further analysis of Charlson co-morbidity score will clarify associated co-morbidities, which may help explain this difference.

    Conclusion
    Surgical resection rates are statistically higher in early stage NSCLC cases presented at MDT than in contemporaneous cases not presented at MDT in our study population. Surgical cure rates for resected patients appear high in both groups. Further data on co-morbidities and identifiable referral patterns, including patients managed outside the public hospital system, may clarify reasons for the disparity in resection rates and enable identification of potentially reversible barriers to treatment.