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G. Lenz
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P1.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 692)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.06-020 - Unequal Access to Health Care System Have a Higher Impact in Upgrading Staging for 8th TNM Ed (ID 10239)
09:30 - 09:30 | Author(s): G. Lenz
- Abstract
Background:
Lung cancer is the leading worldwide cancer related death. Recently, 8[th]edTNM lung cancer was published, changing prognosis. Brazil provides free public healthcare system(SUS); however, we believe access is unequal. 25% of population has private healthcare insurance(SHS). Our objective was to evaluate the impact of the new staging and overall survival comparing patients from SUS and SHS.
Method:
Restrospective analysis of primary lung cancer patients resected between 2011 and 2016. Pathological was classificated according to 8[th]ed TNM. Proportional odds model was used to compare staging and healthcare system,Kaplan-Meier and Log-Rank test for survival analysis.
Result:
267 patients underwent surgery for lung cancer. 52.6%(139)were females, 64.5yo(SD=10.06), adenocarcinoma(60.7%) and 61%(163)from SUS. The upgrade in staging for the current system(8[th]) was significantly higher for SUS(graphic 1)(OD1.55– 95%CI1.00-2.39). Overall median survival was 61months regardless staging, with SHS better survival(p=0.080),graphic 2.Figure 1Figure 2
Conclusion:
Lung cancer new staging is more precise predicting prognosis. An upstaging was expected with new TNM classification. However, a patient from SUS has a 55% higher chance than private care patients of being upstaged not only in T descriptor but also in final staging TNM. Also, SUS had a lower survival tendency. We need to review and address our unequal healthcare system in order better assist our patients.
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-034 - Impact of Travel Distance to Treatment Institution on Survival from Stage I to III Lung Cancer (ID 10350)
09:30 - 09:30 | Author(s): G. Lenz
- Abstract
Background:
Over the last decade, attention and emphasis on regionalization of care for tertiary hospitals have increased in order to improve outcomes, especially in complex surgical procedures such as resection of lung cancer. On the other hand, the growing centralization of cancer services increases patient displacement and may delay access to specialized services and treatment. Impact of travel distance on patients’ outcome from lung cancer is poorly described. The objective of this study is to evaluate whether distance to treatment institution has an impact on survival from patients with lung cancer.
Method:
This is an observational, retrospective study, which included patients with stage I-III lung cancer that performed curative resection at Hospital São Lucas da PUCRS, Brazil. Data was collected from medical charts including demographic, clinical-pathological features and survival. Survival was estimated using the Kaplan-Meier method and log-rank test was used to perform multivariate analysis for prognostic factors. Chi-squared test was used to compare variables between groups.
Result:
Between January 2011 and December 2015, 234 patients with stage I-III lung cancer performed curative resection at Hospital São Lucas da PUCRS. The median age was 65 years (24-85 years) and 50.85% were male. 147 (62.82%) patients were from public health insurance and 87 (37.18%) had private coverage. The distribution of clinical stage ( AJCC 8th ed) was : 116 (49.57%) stage I, 71 (30.34%) stage II and 47 (20.09%) stage III. The median distance to institution was 19.7 (2-1086 km). Patients with public health insurance traveled higher distance than those with private coverage (p= 0.0004). The 3-year overall survival was 86.13% for stage I, 77.74% for stage II and 48.95% for stage III. The distance to institution had no impact in overall survival (p=0.85 for stage I, p= 0.63 for stage II and p= 0.46 for stage III).
Conclusion:
Our study shows that the distance between residence and treatment institution was not found to influence survival of the patients with lung cancer treated by surgery. Importantly, patients with public health insurance, which are in general poorer, have to travel longer distances for curative treatment.
