Management of Patients With Early Stage Lung Cancer - Why Do Some Patients Not Receive Treatment With Curative Intent?

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aut.relation.articlenumber109en_NZ
aut.relation.issue1en_NZ
aut.relation.journalBMC Canceren_NZ
aut.relation.volume20en_NZ
aut.researcherDrabsch, Julie
dc.contributor.authorLawrenson, Ren_NZ
dc.contributor.authorLao, Cen_NZ
dc.contributor.authorBrown, Len_NZ
dc.contributor.authorMoosa, Len_NZ
dc.contributor.authorChepulis, Len_NZ
dc.contributor.authorKeenan, Ren_NZ
dc.contributor.authorKidd, Jen_NZ
dc.contributor.authorMiddleton, Ken_NZ
dc.contributor.authorConaglen, Pen_NZ
dc.contributor.authorDe Groot, Cen_NZ
dc.contributor.authorAitken, Den_NZ
dc.contributor.authorWong, Jen_NZ
dc.date.accessioned2021-01-11T21:17:38Z
dc.date.available2021-01-11T21:17:38Z
dc.date.copyright2020en_NZ
dc.date.issued2020en_NZ
dc.description.abstractBACKGROUNDS: This study aims to understand the factors that influence whether patients receive potentially curative treatment for early stage lung cancer. A key question was whether indigenous Māori patients were less likely to receive treatment. METHODS: Patients included those diagnosed with early stage lung cancer in 2011-2018 and resident in the New Zealand Midland Cancer Network region. Logistic regression model was used to estimate the odds ratios of having curative surgery/ treatment. The Kaplan Meier method was used to examine the all-cause survival and Cox proportional hazard model was used to estimate the hazard ratio of death. RESULTS: In total 419/583 (71.9%) of patients with Stage I and II disease were treated with curative intent - 272 (46.7%) patients had curative surgery. Patients not receiving potentially curative treatment were older, were less likely to have non-small cell lung cancer (NSCLC), had poorer lung function and were more likely to have an ECOG performance status of 2+. Current smokers were less likely to be treated with surgery and more likely to receive treatment with radiotherapy and chemotherapy. Those who were treated with surgery had a 2-year survival of 87.8% (95% CI: 83.8-91.8%) and 5-year survival of 69.6% (95% CI: 63.2-76.0%). Stereotactic ablative body radiotherapy (SABR) has equivalent effect on survival compared to curative surgery (hazard ratio: 0.77, 95% CI: 0.37-1.61). After adjustment we could find no difference in treatment and survival between Māori and non-Māori. CONCLUSIONS: The majority of patients with stage I and II lung cancer are managed with potentially curative treatment - mainly surgery and increasingly with SABR. The outcomes of those being diagnosed with stage I and II disease and receiving treatment is positive with 70% surviving 5 years.en_NZ
dc.identifier.citationBMC Cancer, 20(1), 109.
dc.identifier.doi10.1186/s12885-020-6580-6en_NZ
dc.identifier.issn1471-2407en_NZ
dc.identifier.issn1471-2407en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/13905
dc.publisherBioMed Centralen_NZ
dc.relation.urihttps://bmccancer.biomedcentral.com/articles/10.1186/s12885-020-6580-6
dc.rights© The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectLung cancer; Non-small cell lung cancer; Thoracic surgery; Stereotactic ablative body radiotherapy; Smoking
dc.titleManagement of Patients With Early Stage Lung Cancer - Why Do Some Patients Not Receive Treatment With Curative Intent?en_NZ
dc.typeJournal Article
pubs.elements-id371199
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Health & Environmental Science
pubs.organisational-data/AUT/Health & Environmental Science/Clinical Sciences
pubs.organisational-data/AUT/Health & Environmental Science/Nursing
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