Newly combined data
offer longer-term perspective on an increasingly growing population
Newswise, May 6, 2016 — Patients aged 65 years and older are
living longer after lung cancer surgery, and with older people representing a
rapidly growing proportion of patients diagnosed with lung cancer, this
improved survival is especially significant, according to an article posted
online today byThe Annals of Thoracic Surgery.
The American Cancer Society estimates that the median age at
diagnosis for lung cancer is 70, supporting the premise that lung cancer is
predominantly a disease of the elderly.
Despite this, older patients with cancer are generally
under-represented in clinical cancer trials, including those for lung cancer.
This makes the study by Felix G. Fernandez, MD, from the Emory Clinic in
Atlanta, and colleagues particularly important.
The researchers combined data from lung cancer patients in The
Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD)
with claims data from the Centers for Medicare & Medicaid Services (CMS).
“The new data linkage between STS and CMS provides a more
complete picture of what happens to a large subset of patients beyond the 30
days represented in the STS National Database,” said Dr. Fernandez.
“We now know more about long-term survival after our
interventions, which is important to patients. This information can be included
in the shared decision-making process when discussing treatment options with
patients.”
The GTSD data included 37,009 records for patients 65 years of
age and older who underwent lung cancer surgery between 2002 and 2012.
When merged with CMS data, the records of 26,055 patients were
successfully linked, providing access to vital information related to long-term
patient outcomes. This included hospital readmission rates, reinterventions (a
second procedure), and long-term survival.
According to the National Cancer Institute, the 5-year
survival of all patients diagnosed with lung cancer in the United States is
approximately 17%. Fewer than half of all patients who undergo surgery for lung
cancer survive as long as 5 years.
In examining the STS-CMS linked data, researchers found that
the median survival following lung cancer surgery for pathologic Stage I (early
stage) was 6.7 years, almost 2 years longer than the benchmark 5-year survival
rate.
In addition, the study showed that the 5-year survival rate
for selected older patients with advanced lung cancer who were treated with
surgical therapy was 29.9% for Stage III and 26.7% for Stage IV.
“This greater than expected survival in older patients
selected for operative therapy is noteworthy,” said Dr. Fernandez, “especially
considering that the prevalence of lung cancer is expected to increase as the
population continues to grow older and more people survive into old age.”
According to the US Census Bureau, the elderly population in
the United States is projected to almost double, from the most current estimate
of 43 million in 2012 to 80 million by the year 2050.
Dr. Fernandez said that because clinical decision-making in
older patients can be fairly complex, the long-term patient outcome information
from the STS-CMS linked data certainly will prove beneficial.
“This research effort is important because it will assist in
recommending effective, optimal treatments tailored specifically to older
patients with lung cancer,” he said. “And it is available during a time when we
expect to be seeing more of these patients.”
The STS National Database, established in 1989, represents the
largest cardiothoracic surgery outcomes and quality improvement program in the
world.
The Database has three component databases: the Adult Cardiac
Surgery Database (ACSD), the Congenital Heart Surgery Database, and the GTSD.
The GTSD contains data on nearly 460,000 procedures, including lobectomy and
esophagectomy, and has more than 900 surgeon participants.
Fernandez F, Furnary A, Kosinski A, Onaitis M, Kim S, Boffa D,
Cowper P, Jacobs J, Wright C, Putnam J. Longitudinal Follow-Up of Lung Cancer
Resection from the Society of Thoracic Surgeons General Thoracic Surgery
Database in Patients 65 Years and Older. Ann Thoracic Surg 2016; DOI:
doi.org/10.1016/j.athoracsur.2016.03.034
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