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J. Crequit



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    P1.01 - Poster Session with Presenters Present (ID 453)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Epidemiology/Tobacco Control and Cessation/Prevention
    • Presentations: 1
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      P1.01-039 - Does Distance between Chest and Surgery Departments Impact Outcome in Lung Cancer Patients? Results of KBP-2010-CPHG Study (ID 4585)

      14:30 - 15:45  |  Author(s): J. Crequit

      • Abstract
      • Slides

      Background:
      We studied the impact of the distance between chest and thoracic surgery departments on the outcome of patients followed, for primary lung cancer diagnosed in 2010, in the chest department of 104 French general hospitals participating in KBP-2010-CPHG study.

      Methods:
      6,083 patients with non-small-cell lung cancer (NSCLC) participated in this study. Univariate and multivariate analyses were performed to identify independent factors for surgery and 1-year mortality. Distance from the usual thoracic surgery department in 2010 was collected for each chest department and included in the model as a 4-class variable: 0 km (same hospital), 1­-34 km, 35­-79 km, and ≥80 km.

      Results:
      Overall, 23% of hospitals had a thoracic surgery department; otherwise, mean distance between the hospital and the surgical center was 65 km. 1,157 patients (19%) were operated on; vital status was known for 5,876 patients (97%). Distance was not an independent factor for surgery and for mortality. Independent factors for surgery and mortality are presented in Tables 1 and 2. Table 1- Surgery (multivariate analysis: adjusted odd-ratios)

      OR 95% CI p
      Distance (km)
      0 1
      1-34 0.97 [0.74-1.27] 0.833
      35-79 0.88 [0.66-1.18] 0.399
      >=80 1.02 [0.78-1.32] 0.91
      Age (year)
      Continuous 0.95 [0.94-0.96] <0.001
      Stages
      IV 1
      I 248.18 [172.48-357.11] <0.001
      II 155.78 [107.70-225.32] <0.001
      IIIA 34.23 [24.80-47.25] <0.001
      IIIB 2.33 [1.40-3.89] 0.001
      Histology
      Adenocarcinoma 1
      Squamous-cell carcinoma 0.77 [0.61-0.96] 0.023
      PS
      PS0 1
      PS1 0.58 [0.47-0.71] <0.001
      PS2 0.12 [0.08-0.17] <0.001
      PS3 0.08 [0.04-0.16] <0.001
      PS4 0.07 [0.02-0.32] <0.001
      Table 2- Mortality (multivariate analysis: adjusted hazard-ratios)
      HR 95% CI p
      Distance (km)
      0 1
      1-34 1.02 [0.94-1.11] 0.661
      35-79 1.00 [0.91-1.10] 0.985
      >=80 1.01 [0.93-1.09] 0.887
      Age (year)
      Continuous 1.01 [1.01-1.01] <0.001
      Sex
      Men 1
      Women 0.86 [0.80-0.94] <0.001
      Stages
      IV 1
      I 0.15 [0.13-0.18] <0.001
      II 0.29 [0.25-0.34] <0.001
      IIIA 0.41 [0.37-0.46] <0.001
      IIIB 0.65 [0.58-0.72] <0.001
      PS
      PS0 1
      PS1 1.58 [1.45-1.73] <0.001
      PS2 2.79 [2.52-3.09] <0.001
      PS3 5.75 [5.11-6.48] <0.001
      PS4 10.2 [8.52-12.20] <0.001
      Smoking
      Never-smoker 1
      Former-smoker 1.18 [1.05-1.33] 0.005
      Current-smoker 1.33 [1.18-1.49] <0.001


      Conclusion:
      In 2010, the absence of an on-­site thoracic surgery department did not impair outcome in NSCLC patients managed in the chest departments of French general hospitals.

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