Oncologic Quality Indicators in Thoracic Surgery

Hudson, Jessica; Semenkovich, Tara R.

doi:10.1016/j.thorsurg.2017.04.001

Cited by 17 publications

(13 citation statements)

References 60 publications

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“…45 Third, previous study has demonstrated that PET-CT is helpful for detecting regional and distant metastases. 46 In our study, PET-CT was optional for ESCC patients, which may reduce the specificity in detecting of lymph nodes and distant metastases, especially for the distant metastases. Last, the chemotherapy regimens and prescribed doses vary among ESCC patients in this study, which may influence the results.…”

Section: Discussionmentioning

confidence: 93%

<p>Predicting Prognosis and Adverse Events by Hematologic Markers in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy</p>

Cai¹,

Yu²,

Meng³

2020

CMAR

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Purpose: Our purpose was to evaluate the association between hematologic markers and mortality and adverse events in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (nCRT). Patients and Methods: A total of 311 patients with ESCC treated with nCRT from 2012 to 2014 were enrolled retrospectively. The Kaplan-Meier method with a Log rank test was used to calculate five-year overall survival (OS). Receiver operating characteristic (ROC) curves were plotted to determine the cutoff values for hematologic markers. Multivariate analysis was performed using Cox regression analysis model. Model performance was evaluated by predicted nomogram, concordance index (C-index) and calibration curve. Results: Median follow-up was 22 months. High pretreatment platelet to lymphocyte ratio (PLR, p = 0.047) and systemic immune-inflammation index (SII, p = 0.027) were significantly associated with pathologic complete response (pCR). In multivariate analysis, smoking history, Eastern Cooperative Oncology Group (ECOG) performance status, invasion depth, lymph node metastasis, PLR, and SII were independent factors to predict five-year OS. Multivariate analysis showed a lower neutrophil to lymphocyte ratio (NLR) at baseline (p = 0.007) was significantly associated with development of grade ≥3 hematologic toxicity, and none of inflammatory biomarkers could predict grade ≥3 non-hematologic toxicity or radiation pneumonitis (RP). Conclusion: SII and PLR were independent indicators to predict prognosis in patients with ESCC treated with nCRT, and a lower NLR at baseline was an independent indicator to predict grade ≥3 hematologic toxicity.

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Section: Discussionmentioning

confidence: 93%

<p>Predicting Prognosis and Adverse Events by Hematologic Markers in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy</p>

Cai¹,

Yu²,

Meng³

2020

CMAR

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“…Timely surgical treatment has been proposed as a quality metric for lung cancer care. 30 , 31 Our study provides evidence that patients with clinical stage I disease should ideally receive resection within 12 weeks from the date of CT imaging that suggests lung cancer. However, there are several caveats to including a 12-week period as a proposed quality measure.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Delayed Surgical Treatment and Oncologic Outcomes in Clinical Stage I Non–Small Cell Lung Cancer

et al. 2021

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IMPORTANCEThe association between delayed surgical treatment and oncologic outcomes in patients with non-small cell lung cancer (NSCLC) is poorly understood given that prior studies have used imprecise definitions for the date of cancer diagnosis. OBJECTIVE To use a uniform method to quantify surgical treatment delay and to examine its association with several oncologic outcomes. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study was conducted using a novel data set from the Veterans Health Administration (VHA) system. Included patients had clinical stage I NSCLC and were undergoing resection from 2006 to 2016 within the VHA system. Time to surgical treatment (TTS) was defined as the time between preoperative diagnostic computed tomography imaging and surgical treatment. We evaluated the association between TTS and several delay-associated outcomes using restricted cubic spline functions. Data analyses were performed in November 2021. EXPOSURE Wait time between cancer diagnosis and surgical treatment (ie, TTS). MAIN OUTCOMES AND MEASURESSeveral delay-associated oncologic outcomes, including pathologic upstaging, resection with positive margins, and recurrence, were assessed. We also assessed overall survival. RESULTS Among 9904 patients who underwent surgical treatment for clinical stage I NSCLC, 9539 (96.3%) were men, 4972 individuals (50.5%) were currently smoking, and the mean (SD) age was 67.7 (7.9) years. The mean (SD) TTS was 70.1 (38.6) days. TTS was not associated with increased risk of pathologic upstaging or positive margins. Recurrence was detected in 4158 patients (42.0%) with median (interquartile range) follow-up of 6.15 (2.51-11.51) years. Factors associated with increased risk of recurrence included younger age (hazard ratio [HR] for every 1-year increase in age, 0.992; 95% CI, 0.987-0.997; P = .003), higher Charlson Comorbidity Index score (HR for every 1-unit increase in

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“…The Cardio-Thoracic speciality has been one of the first ones to introduce and champion the risk-adjusted outcome analysis for monitoring and improving quality of care (16,17). However, there is an increasing interest in investigating the possible inclusion of the patient's perspective in these scores (18).…”

Section: Discussionmentioning

confidence: 99%

EORTC QLQ-C30 summary score reliably detects changes in QoL three months after anatomic lung resection for non-small cell lung cancer (NSCLC)

C.¹,

Franks²,

Absolom³

et al. 2018

Lung Cancer

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Oncologic Quality Indicators in Thoracic Surgery

Cited by 17 publications

References 60 publications

<p>Predicting Prognosis and Adverse Events by Hematologic Markers in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy</p>

<p>Predicting Prognosis and Adverse Events by Hematologic Markers in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy</p>

Analysis of Delayed Surgical Treatment and Oncologic Outcomes in Clinical Stage I Non–Small Cell Lung Cancer

EORTC QLQ-C30 summary score reliably detects changes in QoL three months after anatomic lung resection for non-small cell lung cancer (NSCLC)

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