Cost and survival of video-assisted thoracoscopic lobectomy versus open lobectomy in lung cancer patients: a propensity score-matched study

Abstract OBJECTIVES A video-assisted thoracoscopic surgery (VATS) is an accepted alternative to open thoracotomy (OT) in lung cancer patients undergoing lobectomy, but evidence of the benefits of VATS remains inconsistent. The aim of this study was to compare VATS and OT regarding survival, costs and length of hospital stay (LOS). METHODS We identified lung cancer patients (incident 2013) undergoing VATS or OT from German insurance claims data and performed 1:2 propensity score matching. A 3-year survival was analysed using the Kaplan–Meier curves and a univariable Cox model. Group differences in the 3-year lung cancer-related costs and costs of hospital stay with lobectomy were compared via univariable generalized linear gamma models. LOS was compared using the Mann–Whitney–Wilcoxon test. RESULTS After propensity score matching, we compared 294 patients undergoing VATS and 588 receiving OT. We found no differences in the 3-year survival (VATS: 73.8%, OT: 69.2%, P = 0.131) or costs for hospital stay with lobectomy (VATS: €11 921, OT: €12 281, P = 0.573). However, VATS patients had significantly lower lung cancer-related costs (VATS: €20 828, OT: €23 723, P = 0.028) and median postoperative LOS (VATS: 9 days, OT: 11 days, P < 0.001). CONCLUSIONS From a payer's perspective, extending the use of VATS is beneficial, as it shows economic benefits without affecting survival. However, for a more comprehensive assessment of the benefits of VATS from a society’s point of view, further aspects such as patient-reported outcomes and provider-related standby costs need to be investigated further.

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Construction of a Nomogram After Using Propensity Score Matching to Reveal the Prognostic Benefit of Tumor Resection of Stage IV M1a Nonsmall Cell Lung Cancer Patients

Cancer Investigation ◽

10.1080/07357907.2020.1753761 ◽

2020 ◽

Vol 38 (5) ◽

pp. 277-288 ◽

Cited By ~ 1

Author(s):

Guofang Yin ◽

Hua Xiao ◽

Yi Liao ◽

Chengliang Huang ◽

Xianming Fan

Keyword(s):

Lung Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Cancer Patients ◽

Cell Lung Cancer ◽

Tumor Resection ◽

Stage Iv ◽

Nonsmall Cell Lung Cancer ◽

Lung Cancer Patients

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Preoperative radiation may improve the outcomes of resectable IIIA/N2 non‐small‐cell lung cancer patients: A propensity score matching‐based analysis from surveillance, epidemiology, and end results database

Cancer Medicine ◽

10.1002/cam4.1701 ◽

2018 ◽

Vol 7 (9) ◽

pp. 4354-4360 ◽

Cited By ~ 5

Author(s):

Dawei Chen ◽

Haiyong Wang ◽

Xinyu Song ◽

Jinbo Yue ◽

Jinming Yu

Keyword(s):

Lung Cancer ◽

Propensity Score ◽

Small Cell Lung Cancer ◽

Propensity Score Matching ◽

Cancer Patients ◽

Cell Lung Cancer ◽

Small Cell ◽

Preoperative Radiation ◽

Small Cell Lung ◽

Lung Cancer Patients

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Survival difference between EGFR Del19 and L858R mutant advanced non-small cell lung cancer patients receiving gefitinib: a propensity score matching analysis

Chinese Journal of Cancer Research ◽

10.21147/j.issn.1000-9604.2017.06.10 ◽

2017 ◽

Vol 29 (6) ◽

pp. 553-560 ◽

Cited By ~ 4

Author(s):

Minglei Zhuo ◽

◽

Qiwen Zheng ◽

Jun Zhao ◽

Meina Wu ◽

...

Keyword(s):

Lung Cancer ◽

Propensity Score ◽

Small Cell Lung Cancer ◽

Propensity Score Matching ◽

Cancer Patients ◽

Small Cell ◽

Small Cell Lung ◽

Lung Cancer Patients ◽

Propensity Score Matching Analysis ◽

Survival Difference

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Video-assisted thoracoscopic lobectomy versus open lobectomy in the treatment of large lung cancer: propensity-score matched analysis

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01749-8 ◽

2022 ◽

Vol 17 (1) ◽

Author(s):

Jeonghee Yun ◽

Junghee Lee ◽

Sumin Shin ◽

Hong Kwan Kim ◽

Yong Soo Choi ◽

...

Keyword(s):

Lung Cancer ◽

Propensity Score ◽

Hospital Stay ◽

Propensity Score Matching ◽

Thoracoscopic Surgery ◽

Perioperative Outcomes ◽

Vats Lobectomy ◽

Video Assisted ◽

Increased Risk ◽

Open Lobectomy

Abstract Background There are several concerns on thoracoscopic surgery for large tumors because of the increased risk of tumor cell spillage. This study aimed to compare perioperative outcomes and oncological validity between video-assisted thoracoscopic surgery (VATS) and open lobectomy for non-small cell lung cancer (NSCLC) with tumor size > 5 cm. Methods We retrospectively reviewed 355 patients who underwent lobectomy with clinical N0 NSCLC with solid tumor component diameter > 5 cm between January 2009 and December 2016. Patients with tumor invading adjacent structures were excluded. The patients were divided into the VATS group (n = 132) and thoracotomy group (n = 223). Propensity score matching (1:1) was applied. Results After propensity score matching, 204 patients were matched, and clinical characteristics of the two groups were well balanced. The VATS group was associated with a shorter length of hospital stay (6 days vs. 7 days; P < 0.001) than the thoracotomy group. There were no significant differences in the 5-year overall survival (71.5% in VATS vs. 64.4% in thoracotomy, P = 0.390) and 5-year recurrence-free survival (60.1% in VATS vs. 51.5% in thoracotomy, P = 0.210) between the two groups. The cumulative incidence of ipsilateral pleural recurrence was not significantly different between the two groups (12.0% in VATS vs. 7.9% in thoracotomy; P = 0.582). Conclusions In clinical N0 NSCLC larger than 5 cm, VATS lobectomy resulted in shorter hospital stay and similar survival outcome compared to open lobectomy. Based on these results, VATS lobectomy is a valuable option in this subset of patients.

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Selecting a PRO-CTCAE based subset for patient reported symptom monitoring during lung cancer treatment (Preprint)

10.2196/preprints.26574 ◽

2020 ◽

Author(s):

Evalien Veldhuijzen ◽

Iris Walraven ◽

Jose Belderbos

Keyword(s):

Lung Cancer ◽

Clinical Practice ◽

Cancer Patients ◽

Treatment Modalities ◽

European Organization ◽

Specific Patient ◽

Symptom Monitoring ◽

Lung Cancer Patients ◽

Wide Range ◽

Patient Reported

BACKGROUND The Patient Reported Outcomes Version of the Common Terminology Criteria of Adverse Events (PRO-CTCAE) item library covers a wide range of symptoms relevant for oncology care. To enable implementation of PRO-CTCAE-based symptom monitoring in clinical practice, there is a need to select a subset of items relevant for specific patient populations. OBJECTIVE The aim of this study was to develop a PRO-CTCAE subset relevant for patients with lung cancer. METHODS The PRO-CTCAE-based subset for lung cancer patients was generated using a mixed methods approach based on the European Organization for Research and Treatment of Cancer (EORTC) guidelines for developing questionnaires, consisting of a literature review and semi-structured interviews with both lung cancer patients and health care practitioners (HCPs). Both patients and HCPs were queried on the relevance and impact of all PRO-CTCAE items. Results were summarized and, after a final round of expert review, a selection of clinically relevant items for lung cancer patients was made. RESULTS A heterogeneous group of lung cancer patients (n=25) from different treatment modalities and HCPs (n=22) participated in the study. A final list of eight relevant PRO-CTCAE items was created: decreased appetite, cough, shortness of breath, fatigue, constipation, nausea, sadness, and pain (general). CONCLUSIONS Based on literature and both professional and patient input, a subset of PRO-CTCAE items has been identified for use in lung cancer patients in clinical practice. Future work is needed to confirm the validity and effectiveness of this PRO-CTCAE lung cancer subset internationally, and in the real-world clinical practice setting.

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Comparison of Chief Complaints and Patient-Reported Symptoms of Treatment-Naive Lung Cancer Patients Before Surgery

10.21203/rs.3.rs-173687/v1 ◽

2021 ◽

Author(s):

Yaqian Feng ◽

Wei Dai ◽

Yaqin Wang ◽

Jia Liao ◽

Xing Wei ◽

...

Keyword(s):

Lung Cancer ◽

Physical Examination ◽

Cancer Patients ◽

Patient Reported Outcome ◽

Prospective Longitudinal Study ◽

Lung Cancer Patients ◽

Outcome Instrument ◽

Patient Reported ◽

Chief Complaints ◽

Prospective Longitudinal

Abstract BackgroundLung cancer patients without chief complaints have been increasingly identified by physical examination. This study aimed to profile and compare chief complaints with patient-reported symptoms of lung cancer patients before surgery.MethodsData was extracted from a multicenter, prospective longitudinal study (CN-PRO-Lung 1) in China from November 2017 and January 2020. A comparison between chief complaints and patient-reported symptoms was analyzed using the Chi-squared test.ResultsA total of 201 (50.8%) lung cancer patients without chief complaints were found by physical examination at admission, and 195(49.2%) patients had chief complaints. The top 5 chief complaints were coughing (38.1%), expectoration (25.5%), chest pain (13.6%), hemoptysis (10.6%), and shortness of breath (5.1%). There were significantly more patients with chief complaints of coughing (38.1% vs. 15.0 %, P <0.001) and pain (20.5% vs. 6.9%, P<0.001) than those with the same symptoms rated ≥4 via MDASI-LC. There were less patients with chief complaints of fatigue (1.8% vs. 10.9%, P<0.001), nausea (0.3% vs. 2.5%, P=0.006), and vomiting (0.3% vs. 1.8%, p=0.032) than those with the same symptoms rated ≥4 via MDASI-LC. In patients without chief complaints, the five most common moderate to severe patient-reported symptoms were disturbed sleep (19.5%), distress (13.5%), dry mouth (13%), sadness (12%), and difficulty remembering (11.1%).ConclusionsSymptoms of lung cancer patients not included in the chief complaint could be identified via a patient-reported outcome instrument, suggesting the necessity of implementing the patient-reported outcome assessment before lung cancer surgery for better patient care.

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