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Impact on survival of modelling increased surgical resection rates in patients with non-small-cell lung cancer and cardiovascular comorbidities: a VICORI study.

Abstract：

BACKGROUND:The impact of cardiovascular disease (CVD) comorbidity on resection rates and survival for patients with early-stage non-small-cell lung cancer (NSCLC) is unclear. We explored if CVD comorbidity explained surgical resection rate variation and the impact on survival if resection rates increased. METHODS:Cancer registry data consisted of English patients diagnosed with NSCLC from 2012 to 2016. Linked hospital records identified CVD comorbidities. We investigated resection rate variation by geographical region using funnel plots; resection and death rates using time-to-event analysis. We modelled an increased propensity for resection in regions with the lowest resection rates and estimated survival change. RESULTS:Among 57,373 patients with Stage 1-3A NSCLC, resection rates varied considerably between regions. Patients with CVD comorbidity had lower resection rates and higher mortality rates. CVD comorbidity explained only 1.9% of the variation in resection rates. For every 100 CVD comorbid patients, increasing resection in regions with the lowest rates from 24 to 44% would result in 16 more patients resected and alive after 1 year and two fewer deaths overall. CONCLUSIONS:Variation in regional resection rate is not explained by CVD comorbidities. Increasing resection in patients with CVD comorbidity to the levels of the highest resecting region would increase 1-year survival.

journal_name

Br J Cancer

journal_title

British journal of cancer

authors

Welch CA,Sweeting MJ,Lambert PC,Rutherford MJ,Jack RH,West D,Adlam D,Peake M

doi

10.1038/s41416-020-0869-8

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

471-479

issue

3

eissn

0007-0920

issn

1532-1827

pii

10.1038/s41416-020-0869-8

journal_volume

123

pub_type

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