Impact on survival of modelling increased surgical resection rates in patients with Non-Small Cell Lung Cancer and cardiovascular comorbidities: a VICORI study
Catherine Welch
Michael Sweeting
Paul Lambert
Mark Rutherford
Ruth Jack
Douglas West
David Adlam
Michael Peake
2381/12011514.v1
https://figshare.le.ac.uk/articles/journal_contribution/Impact_on_survival_of_modelling_increased_surgical_resection_rates_in_patients_with_Non-Small_Cell_Lung_Cancer_and_cardiovascular_comorbidities_a_VICORI_study/12011514
<p>Background</p>
<p>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.</p>
<p>Methods</p>
<p>Cancer registry data consisted of English patients diagnosed
with NSCLC from 2012-2016. 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.</p>
<p>Results</p>
<p>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 2 fewer deaths overall.</p>
<p>Conclusion</p>
<p>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.</p>
2020-04-02 09:10:29
Uncategorised value