Impact on survival of modelling increased surgical resection rates in patients with Non-Small Cell Lung Cancer and cardiovascular comorbidities: a VICORI study WelchCatherine SweetingMichael LambertPaul RutherfordMark JackRuth WestDouglas AdlamDavid PeakeMichael 2020 <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>