TY - JOUR
T1 - Analyzing the effect of physician assignment in the survival of patients with advanced non-small-cell lung cancer
AU - Wheatley-Price, Paul
AU - Jonker, H.
AU - Al-Baimani, K.
AU - Mhang, T.
AU - Nicholas, G.
AU - Goss, G.
AU - Laurie, S. A.
N1 - Publisher Copyright:
© 2020 Multimed Inc.
PY - 2020
Y1 - 2020
N2 - Background Non-small-cell lung cancer (nsclc) is the most common cause of cancer deaths worldwide, with a 5-year survival of 17%. The low survival rate observed in patients with nsclc is primarily attributable to advanced stage of disease at diagnosis, with more than 50% of cases being stage iv at presentation. For patients with advanced disease, palliative systemic therapy can improve overall survival (os); however, a recent review at our institution of more than 500 consecutive cases of advanced nsclc demonstrated that only 55% of the patients received palliative systemic therapy. What is unknown to date is whether that observed low rate of systemic therapy in our previous study is uniform across oncologists. Methods With ethics approval, we performed a retrospective analysis of newly diagnosed patients with stage iv nsclc seen as outpatients at our institution between 2009 and 2012 by 4 different oncologists. Demographics, treatment, and survival data were collected and compared for the 4 oncologists. Results The 4 oncologists saw 528 patients overall, with D seeing 115; L, 158; R, 137; and M, 118. Significant variation was observed in the proportion receiving 1 line or more of chemotherapy: D, 60%; L, 65%; R, 43%; and M, 52%. Physician assignment was not associated with a difference in median os, with D’s cohort having a median os of 6.8 months; L, 8.4 months; R, 7.0 months; and M, 7.0 months. Conclusions Practice size and proportion of patients treated varied between oncologists, but those differences did not translate into significantly different survival outcomes for patients.
AB - Background Non-small-cell lung cancer (nsclc) is the most common cause of cancer deaths worldwide, with a 5-year survival of 17%. The low survival rate observed in patients with nsclc is primarily attributable to advanced stage of disease at diagnosis, with more than 50% of cases being stage iv at presentation. For patients with advanced disease, palliative systemic therapy can improve overall survival (os); however, a recent review at our institution of more than 500 consecutive cases of advanced nsclc demonstrated that only 55% of the patients received palliative systemic therapy. What is unknown to date is whether that observed low rate of systemic therapy in our previous study is uniform across oncologists. Methods With ethics approval, we performed a retrospective analysis of newly diagnosed patients with stage iv nsclc seen as outpatients at our institution between 2009 and 2012 by 4 different oncologists. Demographics, treatment, and survival data were collected and compared for the 4 oncologists. Results The 4 oncologists saw 528 patients overall, with D seeing 115; L, 158; R, 137; and M, 118. Significant variation was observed in the proportion receiving 1 line or more of chemotherapy: D, 60%; L, 65%; R, 43%; and M, 52%. Physician assignment was not associated with a difference in median os, with D’s cohort having a median os of 6.8 months; L, 8.4 months; R, 7.0 months; and M, 7.0 months. Conclusions Practice size and proportion of patients treated varied between oncologists, but those differences did not translate into significantly different survival outcomes for patients.
KW - Chemotherapy
KW - Non-small-cell lung cancer
KW - Physician effect
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U2 - 10.3747/co.27.5291
DO - 10.3747/co.27.5291
M3 - Article
C2 - 32218658
AN - SCOPUS:85081260005
SN - 1198-0052
VL - 27
SP - 34
EP - 38
JO - Current Oncology
JF - Current Oncology
IS - 1
ER -