Patterns of care for people with small cell lung cancer in Victoria, 2011-19: a retrospective, population-based registry data study

Huang, J; Faisal, W; Brand, M; Smith, S; Alexander, M; Briggs, L; Conron, M; Duffy, M; John, T; Langton, D; Lesage, J; MacManus, M; Mitchell, P; Olesen, I; Parente, P; Philip, J; Samuel, E; Torres, J; Underhill, CR; Zalcberg, JR; Harden, S; Stirling, R

Author(s): Huang, J; Faisal, W; Brand, M; Smith, S; Alexander, M; Briggs, L; Conron, M; Duffy, M; John, T; Langton, D; Lesage, J; MacManus, M; Mitchell, P; Olesen, I; Parente, P; Philip, J; Samuel, E; Torres, J; Underhill, CR; Zalcberg, JR; Harden, S; Stirling, R;
Details: Publication Year 2023-08-07,Volume 219,Issue #3,Page 120-126
Journal Title: Medical Journal of Australia
Publication Type: Research article
Abstract: OBJECTIVES: To report stage-specific patterns of treatment and the influence of management and treatment type on survival rates for people newly diagnosed with small cell lung cancer (SCLC). DESIGN: Cross-sectional patterns of care study; analysis of data prospectively collected for the Victorian Lung Cancer Registry (VLCR). SETTING, PARTICIPANTS: All people diagnosed with SCLC in Victoria during 1 April 2011 - 18 December 2019. MAIN OUTCOME MEASURES: Stage-specific management and treatment of people with SCLC; median survival time. RESULTS: During 2011-19, 1006 people were diagnosed with SCLC (10.5% of all lung cancer diagnoses in Victoria); their median age was 69 years (interquartile range [IQR], 62-77 years), 429 were women (43%), and 921 were current or former smokers (92%). Clinical stage was defined for 896 people (89%; TNM stages I-III, 268 [30%]; TNM stage IV, 628 [70%]) and ECOG performance status at diagnosis for 663 (66%; 0 or 1, 489 [49%]; 2-4, 174 [17%]). The cases of 552 patients had been discussed at multidisciplinary meetings (55%), 377 people had received supportive care screening (37%), and 388 had been referred for palliative care (39%). Active treatment was received by 891 people (89%): chemotherapy, 843 (84%); radiotherapy, 460 (46%); chemotherapy and radiotherapy, 419 (42%); surgery, 23 (2%). Treatment had commenced within fourteen days of diagnosis for 632 of 875 patients (72%). Overall median survival time from diagnosis was 8.9 months (IQR, 4.2-16 months; stage I-III: 16.3 [IQR, 9.3-30] months; stage IV: 7.2 [IQR, 3.3-12] months). Multidisciplinary meeting presentation (hazard ratio [HR], 0.66; 95% CI, 0.58-0.77), multimodality treatment (HR, 0.42; 95% CI, 0.36-0.49), and chemotherapy within fourteen days of diagnosis (HR, 0.68; 95% CI, 0.48-0.94) were each associated with lower mortality during follow-up. CONCLUSION: Rates of supportive care screening, multidisciplinary meeting evaluation, and palliative care referral for people with SCLC could be improved. A national registry of SCLC-specific management and outcomes data could improve the quality and safety of care.
Publisher: Wiley
Keywords: Humans; Female; Middle Aged; Aged; Male; *Small Cell Lung Carcinoma/drug therapy; Retrospective Studies; Cross-Sectional Studies; Routinely Collected Health Data; *Lung Neoplasms/epidemiology/therapy; Cancer; Chemotherapy; Guidelines as topic; Lung diseases; Neoplasms, epidemiology; Quality assurance, health care; Quality of health care; Radiotherapy
Department(s): Pharmacy; Medical Oncology; Radiation Oncology
PubMed ID: 37365486
Publisher's Version: https://doi.org/10.5694/mja2.52017
Open Access at Publisher's Site: https://doi.org/10.5694/mja2.52017
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-09-19 07:39:55

Last Modified: 2023-09-19 07:40:43