Comprehensive treatment availability improves outcomes for veterans with early-stage lung cancer, according to study findings presented at the International Association for the Study of Lung Cancer (IASLC)’s 2024 World Conference on Lung Cancer, held in San Diego, California.1
The study, led by Washington University in St. Louis School of Medicine and the VA St. Louis Health System, underscores the importance of multidisciplinary care in the Veterans Health Administration (VHA).
Early-stage lung cancer is predominantly treated with lung resection or stereotactic body radiotherapy (SBRT). The VHA performs lung resections at approximately 100 medical centers. However, fewer than half of these centers offer in-house SBRT, leading to variability in comprehensive lung cancer care across VA sites. This study aimed to evaluate the impact of this variability on patient outcomes.
The researchers retrospectively analyzed data on 6289 patients with clinical early-stage non-small cell lung cancer (NSCLC) treated with lung resection at VHA medical centers between 2006 and 2016. They compared outcomes between patients treated at centers offering both surgery and SBRT and those treated at centers offering surgery only. The study analyzed short-term and long-term outcomes, including quality of care metrics (VALCAN-O operative quality score), patient selection metrics (VALCAN-M mortality risk score), and overall survival.
Of the patients, 4673 were treated at surgery-only sites, while 1616 were treated at sites offering both surgery and SBRT. The sociodemographic factors were similar between the groups.
Patients treated at surgery + SBRT sites had significantly higher operative quality scores and lower operative mortality risk scores, the researchers wrote. Short-term outcomes were also better at these sites, with lower rates of 30-day major complications, and better 30-day and 90-day mortalities.
“With a median follow-up of 6.3 (2.6-11.6) years, 5-year overall survival was higher at surgery + SBRT sites (59.4% vs 56.9%, P=0.02,” the researchers wrote.
The study researchers then concluded that the “short and long term outcomes for veterans with early-stage NSCLC undergoing lung resection were better at VA facilities with both thoracic surgery and SBRT capabilities. These findings support recommendations to increase the SBRT at all VA medical centers offering lung cancer care.”
Reference
- 1. Heiden BT, Eaton DB, Chang SH, et al. Comprehensive treatment availability is associated with improved outcomes among veterans with early-stage lung cancer treated at VA medical centers. Poster presentation. Presented at the 2024 World Conference on Lung Cancer; September 7-10, 2024; San Diego, CA.