Contemporary patterns of racial/ethnic disparities in surgical treatment and overall survival for localized resectable non-small cell lung cancer in the United States.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20057-e20057
Author(s):  
Oladimeji Akinboro ◽  
Stanley Madu Nwabudike ◽  
Michael Voisine ◽  
Kevan L. Hartshorn ◽  
Marjory Charlot
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Native Americans ◽  
Ethnic Groups ◽  
The United States ◽  
Pacific Islanders ◽  
Small Cell Lung ◽  
Stage Ia ◽  
Iiia Nsclc ◽  
Racial Ethnic

e20057 Background: Racial disparities in the surgical treatment of early stage lung cancers are well documented for African-Americans relative to Whites. However, there is a paucity of contemporary data regarding lung cancer treatment disparities for other minority racial/ethnic groups. We sought to compare: i) contemporary rates of surgery, ii) and overall survival (OS) for resectable non-small cell lung cancer (NSCLC), across several minority populations in the United States (US). Methods: We identified new diagnoses of stages IA-IIIA NSCLC (AJCC7) from 2010-2015 among adults (20 years+) in the Surveillance, Epidemiology, and End Results (SEER) 18 registry. We compared rates of surgery +/- radiotherapy (RT) for stage IA NSCLC, and surgery +/- RT +/- chemotherapy for stages IB–IIIA NSCLC, among the following racial/ethnic groups: Non-Hispanic Whites (whites), Non-Hispanic Blacks (blacks), Hispanics, Asians or Pacific Islanders, and American Indians/Alaska Natives (native Americans). We also calculated and compared 5-year OS rates across these groups. Results: There were 339,912 cases of newly-diagnosed stages IA, IB, IIA, IIB, and IIIA NSCLC identified for analysis. Receipt of surgical treatment +/- RT for stage IA NSCLC was lower in blacks (63.5%), and native Americans (64.2%) than whites (69.4%), as well as for stage IIB NSCLC (whites 66.7%; blacks 56.7%; native Americans 55.6%). Blacks had lower rates of surgery relative to whites across the other NSCLC stages studied but no disparities were noted for Hispanics and Asians/Pacific Islanders. 5-year age-adjusted OS for stage IA-IIIA NSCLC were significantly lower for native Americans (62.3%, 95% CI 58.1%, 66.3%) and blacks (68.1%; 95% CI 67.4, 68.9%) relative to whites (69.2%; 95% CI 69.0%, 69.5%) with relative risks of 1.11 (95% CI 1.04, 1.19) and 1.02 (95% CI 1.01, 1.03), respectively. This inferior OS persisted for blacks even among those treated with cancer-directed surgery. Conclusions: Disparities in rates of surgical treatment and OS for resectable NSCLC persist for blacks and native Americans. Although it is unclear if inferior OS outcomes for blacks are solely attributable to lower rates of surgery, systems-based interventions are needed to help ensure equal and optimal receipt of surgery for resectable NSCLC across all racial/ethnic groups in the US.

scholarly journals Sublobar Resection for Clinical Stage IA Non–small-cell Lung Cancer in the United States

2016 ◽  
Vol 17 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Paul J. Speicher ◽  
Lin Gu ◽  
Brian C. Gulack ◽  
Xiaofei Wang ◽  
Thomas A. D'Amico ◽  
...  
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Clinical Stage ◽  
The United States ◽  
Small Cell ◽  
Sublobar Resection ◽  
Small Cell Lung ◽  
Clinical Stage Ia ◽  
Stage Ia

scholarly journals Research on surgical treatment for non-small cell lung cancer from 2009 to 2018: a bibliometric analysis

2019 ◽  
Author(s):  
Haihua Zhang ◽  
Long Li ◽  
Lei Zhang ◽  
Junqiang LI ◽  
Guizhou Gao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Thoracic Surgery ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Locally Advanced ◽  
The United States ◽  
Small Cell ◽  
Small Cell Lung ◽  
Systematic Analysis

Abstract Background The objective of this study was to analyze the scientific outputs of surgical treatment for non-small cell lung cancer (NSCLC). Methods We explored the research topic from the Web of Science Core Collection for period 2009-2018. Based on Cite Space IV and VOS viewer, we explored distribution of time, journals, countries/ regions, institutions, authors, disciplines, keywords, and burst terms associated with this topic. Results According to an analysis of 3175 papers, the European Journal of Cardio Thoracic Surgery published the most papers and the United States contributed the most publications in this area. Albain KS from Loyola University occupied the highest co-citation score. The burst terms of ‘morbidity’, ‘elderly patient’, and ‘classification’ were ranked first as research indicators. Conclusions We were able to construct a systematic analysis of studies related to surgical treatment for NSCLC by providing new perspectives and valuable information. The treatment for locally advanced NSCLC and assisted thoracic surgery were terms that appear to have developmental trends. However, further attention and innovation are still needed in this area.

scholarly journals Overuse of Diagnostic Brain Imaging Among Patients With Stage IA Non–Small Cell Lung Cancer

2020 ◽  
Vol 18 (5) ◽  
pp. 547-554
Author(s):  
Michael G. Milligan ◽  
Angel M. Cronin ◽  
Yolonda Colson ◽  
Kenneth Kehl ◽  
Debra N. Yeboa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Brain Imaging ◽  
Cell Lung Cancer ◽  
Brain Mri ◽  
The United States ◽  
Small Cell ◽  
Small Cell Lung ◽  
Factors Associated ◽  
Stage Ia

Background: Among patients diagnosed with stage IA non–small cell lung cancer (NSCLC), the incidence of occult brain metastasis is low, and several professional societies recommend against brain imaging for staging purposes. The goal of this study was to characterize the use of brain imaging among Medicare patients diagnosed with stage IA NSCLC. Methods: Using data from linked SEER-Medicare claims, we identified patients diagnosed with AJCC 8th edition stage IA NSCLC in 2004 through 2013. Patients were classified as having received brain imaging if they underwent head CT or brain MRI from 1 month before to 3 months after diagnosis. We identified factors associated with receipt of brain imaging using multivariable logistic regression. Results: Among 13,809 patients with stage IA NSCLC, 3,417 (25%) underwent brain imaging at time of diagnosis. The rate of brain imaging increased over time, from 23.5% in 2004 to 28.7% in 2013 (P=.0006). There was significant variation in the use of brain imaging across hospital service areas, with rates ranging from 0% to 64.0%. Factors associated with a greater likelihood of brain imaging included older age (odds ratios [ORs] of 1.16 for 70–74 years, 1.13 for 75–79 years, 1.31 for 80–84 years, and 1.46 for ≥85 years compared with 65–69 years; all P<.05), female sex (OR, 1.09; P<.05), black race (OR 1.23; P<.05), larger tumor size (ORs of 1.23 for 11–20 mm and 1.28 for 21–30 mm tumors vs 1–10 mm tumors; all P<.05), and higher modified Charlson-Deyo comorbidity score (OR, 1.28 for score >1 vs score of 0; P<.05). Conclusions: Roughly 1 in 4 patients with stage IA NSCLC received brain imaging at the time of diagnosis despite national recommendations against the practice. Although several patient factors are associated with receipt of brain imaging, there is significant geographic variation across the United States. Closer adherence to clinical guidelines is likely to result in more cost-effective care.

scholarly journals Assessing Lung Cancer Incidence Disparities Between Puerto Ricans and Other Racial/Ethnic Groups in the United States, 1992–2010

2015 ◽  
Vol 17 (3) ◽  
pp. 971-975 ◽  
Author(s):  
William A. Calo ◽  
Erick Suárez ◽  
Marievelisse Soto-Salgado ◽  
Rafael A. Quintana ◽  
Ana P. Ortiz
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Ethnic Groups ◽  
Cancer Incidence ◽  
Puerto Ricans ◽  
The United States ◽  
Lung Cancer Incidence ◽  
Racial Ethnic

scholarly journals Adoption of Stereotactic Body Radiotherapy for Stage IA Non–Small Cell Lung Cancer Across the United States

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Jordan A. Holmes ◽  
Timothy M. Zagar ◽  
Ronald C. Chen
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Stereotactic Body Radiotherapy ◽  
Treatment Options ◽  
The United States ◽  
Small Cell ◽  
Dose Fractionation ◽  
Small Cell Lung ◽  
Stage Ia

Abstract Background Stereotactic body radiotherapy (SBRT) is a treatment option for stage I non–small cell lung cancer (NSCLC), providing a potentially curative therapy for patients who are nonsurgical candidates. This study describes the adoption of SBRT vs other treatment options across the United States, as well as commonly used dose-fractionation regimens. Methods We analyzed patients in the National Cancer Data Base. A total of 107 233 stage IA NSCLC patients diagnosed from 2008 to 2013 were included. We described the proportions of patients who received different surgical and radiation treatment options by year. A multivariable model was constructed to assess factors associated with patients receiving SBRT. In patients who received SBRT, we described the proportion of patients who received common dose/fractionation regimens. Results Use of SBRT increased from 6.7% to 16.3% from 2008 to 2013, with a corresponding decrease in lobectomy/pneumonectomy (49.5% to 43.7%). The rates of wedge resection, conventional radiotherapy, and no treatment remained relatively constant. Adoption of SBRT was lowest in small community centers (8.6% of patients by 2013). On multivariable analysis, older age and treatment at larger centers were associated with higher SBRT receipt, and black race and higher comorbidity were associated with lower SBRT receipt. There was statistically significant geographic variation. Common SBRT schemes were 10 Gy × 5 (19%), 18–20 Gy × 3 (31%), and 12 Gy × 4 (16%). Conclusions SBRT adoption has been modest over time and has not substantially replaced less curative treatments. Lack of access to this technology in smaller cancer centers may have partly contributed to the slow adoption.

Surgical treatment strategy for small-sized, non-small cell lung cancer: A proposed algorithm for limited resection

2010 ◽  
Vol 24 (7) ◽  
pp. 1004-1010 ◽  
Author(s):  
Masayoshi Inoue ◽  
Masato Minami ◽  
Noriyoshi Sawabata ◽  
Yoshihisa Kadota ◽  
Yasushi Shintani ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Treatment Strategy ◽  
Small Cell ◽  
Limited Resection ◽  
Small Cell Lung
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