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C. Houston-Harris
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P1.13 - Radiology/Staging/Screening (ID 699)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.13-011 - Prospective Cohort Study of Patterns of Staging and Treatment Selection with or Without Multidisciplinary (MD) Care (ID 10099)
09:30 - 09:30 | Author(s): C. Houston-Harris
- Abstract
Background:
Lung cancer survival depends on accurate staging and treatment selection. Because staging and treatment are increasingly multi-modal, we examined staging and treatment selection practices with or without MD care in a single healthcare system.
Method:
Eligible patients had untreated lung cancer, ECOG performance status of 0-2, and gave informed consent. Comparisons were made between patients seen in a co-located MD clinic (MDC) and those receiving standard care (SC). Some SC patients were discussed at a multidisciplinary tumor conference (MDTC), thus allowing comparison of MD care to pure SC and MDTC. Diagnostic, staging, treatment procedures and patient outcomes were prospectively recorded. Staging thoroughness was defined as biopsy of stage-defining lesion; bimodality staging (PET+CT or CT+invasive staging biopsy); trimodality staging (PET+CT+invasive staging biopsy). Stage migration was determined comparing baseline stage (from first radiologic scan) to final clinical stage prior to treatment. Stage-appropriate treatment was defined by NCCN guidelines using final, pre-treatment stage. Chi-squared test and multivariable logistic regressions adjusted for age, sex, and histology were used to examine differences between patient cohorts.
Result:
Of 527 patients, 178 were MDC, 77 MDTC, 272 SC. Race and gender were similar but median age (67 v 66 v 69 (p=0.0032) and insurance distribution (p=0.0021) differed across groups. MDC tended to have more thorough staging than MDTC and SC. Significant differences were observed in staging migration and appropriate treatment, favoring MDC and MDTC patients (Table 1). After adjusting for age, sex, and histology, MCD and MDTC were 2-3 times more likely to have more thorough staging and overall stage appropriate treatment (Table 1). Figure 1
Conclusion:
Care within a structured MDC environment (whether co-located MDC or MDTC) was associated with significantly more thorough staging processes and higher rates of stage-appropriate use of treatment modalities than usual care. Survival analysis will be reported when data are mature.
