Variations in cancer centers' use of cytology for the diagnosis of small cell lung carcinoma in the National Cancer Data Base

Gansler, Ted; Fedewa, Stacey A.; Lin, Chun Chieh; Jemal, Ahmedin; Ward, Elizabeth

doi:10.1002/cncy.21610

Cited by 9 publications

(4 citation statements)

References 13 publications

(20 reference statements)

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“…Previous studies note earlier adoption of innovative cancer treatments and procedures in specialized cancer centers and vary based on physician-related factors, including the practice of their peers [20,21,22]. We did not observe a significant difference in the use or early adoption of chemotherapy by facility type.…”

Section: Discussioncontrasting

confidence: 36%

Trends and Predictors of Chemotherapy Use among Thyroid Cancer Patients in the National Cancer Database (2004-2013)

2016

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Background/Aim: Beginning in 2011, the Food and Drug Administration (FDA) approved the use of multikinase inhibitors (MKIs) for medullary thyroid cancers (MTCs), and in 2013 MKIs were approved for metastatic differentiated thyroid cancers (DTCs). However, little is known about the use of chemotherapy in thyroid cancer patients. Thus, the goal of our study was to describe patterns of chemotherapy use, including MKIs, among DTC and MTC patients in the National Cancer Database (NCDB). Methods: Chemotherapy use, along with other treatment types (surgery and radiation), was assessed between 2004 and 2013. The primary predictor was the year of diagnosis (2004-2010 and 2011-2013), based on the FDA's approval of chemotherapy for MTC (2011). Baseline use of MKIs in DTCs in 2013 was also examined. Multivariable logistic regression was used to estimate odds ratios (OR) and 95% CI of receipt of chemotherapy. Results: Overall, 199,654 patients were included in our analytic sample with 194,667 nonmetastatic DTCs, 1,633 metastatic DTCs, and 3,354 MTCs. Among MTCs, chemotherapy use significantly increased from 3.1% in 2004-2010 to 5.0% in 2011-2013 (p = 0.018) in unadjusted and adjusted (OR = 1.54, 95% CI: 1.00, 2.36) analyses. In metastatic DTCs, 4.9% of patients received chemotherapy in 2013, which was not significantly higher than in previous years (p = 0.755). Conclusions: Overall, chemotherapy use among MTCs increased marginally following the FDA's approval of MKIs in 2011, although their use remains very low. MKIs were infrequently used in metastatic DTCs in 2013. Future studies examining patterns of chemotherapy in thyroid cancer patients are warranted.

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Section: Discussioncontrasting

confidence: 36%

Trends and Predictors of Chemotherapy Use among Thyroid Cancer Patients in the National Cancer Database (2004-2013)

2016

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“…It appears noteworthy that a 2014 review of the College of American Pathologists’ Q‐Probes peer‐comparison quality assurance program mentions the automated collection of larger data sets as a part of future programs that would improve cost‐effectiveness and permit more detailed statistical analysis . Results of the current study and those from a similar analysis of definitive cytological diagnoses of small cell lung cancer support the value of registry data in comparing patterns of diagnostic practices among facilities.…”

Section: Discussionmentioning

confidence: 51%

Variations in cancer centers’ use of cytology for the diagnosis of unresectable pancreatic cancer in the National Cancer Data Base

Gansler

Fedewa

Lin

et al. 2016

Cancer Cytopathology

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BACKGROUND:Cytology is an accurate, safe, cost-effective, and guideline-recommended method for pancreatic cancer diagnosis, particularly for unresectable disease. However, to the authors' knowledge, the frequency and determinants of its use have not been described to date. The current study examined patterns of cytological diagnosis among patients with unresectable pancreatic cancer by treatment facility type and by patient characteristics. METHODS: The prevalence of definitive cytological diagnosis (cytology only, without confirmatory histology) versus histological diagnosis (with or without accompanying cytology) was examined in National Cancer Data Base records of 13,657 patients diagnosed with unresectable (American Joint Committee on Cancer stages III and IV) pancreatic cancer in 2011 and 2012 who did not undergo surgical treatment (mode of diagnosis could not be ascertained for surgical patients). Associations between definitive cytological diagnosis and patient and facility characteristics were assessed using multivariable marginal logistic regression models and expressed as odds ratios (OR) and 95% confidence intervals (95% CIs). RESULTS: Overall, 26.8% of unresectable pancreatic cancer cases were definitively diagnosed with cytology. The prevalence of cytological diagnosis ranged from 16.5% in community cancer programs and 22.6% in comprehensive community cancer programs to 31.3% in academic/teaching/research cancer programs and 43.2% in National Cancer Institute-designated cancer programs (P<.001). Compared with patients diagnosed in National Cancer Institute-designated cancer programs, those from community cancer programs (OR, 0.29; 95% CI, 0.20-0.42), comprehensive community cancer programs (OR, 0.42; 95% CI, 0.31-0.59), and academic/teaching/research cancer programs (OR, 0.60; 95% CI, 0.43-0.84) had lower odds of being diagnosed with cytology. CONCLUSIONS: Greater than 25% of unresectable pancreatic cancers were diagnosed definitively with cytology, with wide variation in its use by facility type, suggesting opportunities for quality improvement interventions that increase the use of cytology. Cancer Cytopathol 2016;124:791-800.

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“…From what is reported in the literature, the diagnosis of SCLC is made on cytology samples in 15-31% patients as many patients have a broadly metastasized disease at the time of diagnosis [18]. These percentages may vary even more in the clinical practice then reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Influence of preanalytical variables on performance of delta-like protein 3 (DLL3) predictive immunohistochemistry

et al. 2020

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DLL3 might become a predictive immunohistochemical marker in small cell carcinoma of the lung (SCLC). We investigated the influence of pre-analytical handling of samples on the performance of DLL3 immunohistochemistry (IHC) using DLL3 SP347 ready to use assay (Ventana). DLL3 positive cell lines were subjected to different experimental conditions mimicking the pre-analytical variation in daily clinical practice. Formalin fixation of 24 h led to the most optimal results of DLL3 IHC. Longstanding fixation in Cytolyt, methanol-based fixative for cytology samples, but also decalcification using a mix of formic- and hydrochloracid resulted in decreased DLL3 staining. Postponed staining of blanc slides for 3 months also decreased DLL3 IHC. Postponed fixation of the SCLC cell lines did not influence the performance of DLL3 IHC, although this might be different in the tissues than in the cell lines. In conclusion, different pre-analytical variables decrease the performance of DLL3 IHC. These findings are essential for implementing novel predictive immunohistochemical biomarkers in daily pathology practice.

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Variations in cancer centers' use of cytology for the diagnosis of small cell lung carcinoma in the National Cancer Data Base

Cited by 9 publications

References 13 publications

Trends and Predictors of Chemotherapy Use among Thyroid Cancer Patients in the National Cancer Database (2004-2013)

Trends and Predictors of Chemotherapy Use among Thyroid Cancer Patients in the National Cancer Database (2004-2013)

Variations in cancer centers’ use of cytology for the diagnosis of unresectable pancreatic cancer in the National Cancer Data Base

Influence of preanalytical variables on performance of delta-like protein 3 (DLL3) predictive immunohistochemistry

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