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N. Navani
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P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.03-010 - Characteristics of Lung Cancer Patients Diagnosed Following Emergency Admission (ID 5091)
14:30 - 15:45 | Author(s): N. Navani
- Abstract
Background:
The proportion of patients with cancers diagnosed via the emergency route and their demographic characteristics vary according to tumour type[1]. Patients with lung cancers diagnosed as emergency presentations suffer worse outcomes[2]. The aim of this observational study was to determine the characteristics of a sample of patients with new lung cancers presenting through the emergency route.
Methods:
Clinical and demographic patient data were extracted from the London Cancer Registry. Data relating to emergency presentations of lung cancer were collected prospectively between January and August 2013 from nine acute trusts across northeast and central London and west Essex. Clinical and demographic characteristics were collated. The total number of emergency presentations were compared to the total numbers of lung cancers diagnosed within the same region over the corresponding time frame from the National Lung Cancer Audit data (NLCA).
Results:
Figure 1From the NLCA, there were an estimated 964 lung cancers recorded within the London cancer region during the study period. Of these, 310 (32%) lung cancers were recorded in the London Cancer registry as having presented via the emergency route. The median age of these patients was 73. The majority of patients were white and from areas of increased social deprivation. The proportion of patients presenting with stage IV disease was 67%, while 58% had a performance status of 0-2. The most common presenting symptoms were respiratory. 95% of patients were treated with palliative rather than curative intent.
Conclusion:
Approximately one third of new lung cancers within London Cancer are diagnosed following emergency admission. The next phase of work includes incorporating results from the London Cancer Alliance to provide pan-London data and to develop tools in primary care to identify these patients prior to emergency admission.
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P3.03 - Poster Session with Presenters Present (ID 473)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.03-038 - Improving Quality of Care and Outcomes for Patients Diagnosed with Pleural Mesothelioma in England (ID 5066)
14:30 - 15:45 | Author(s): N. Navani
- Abstract
Background:
Mesothelioma data has been collected by the National Lung Cancer Audit (NLCA) since it was introduced in 2004 to improve standards of care for patients in the UK and ultimately improve outcomes. The first mesothelioma-specific report combining data submitted to the audit from 2008-2012 was reported in 2014, capturing approximately 85 per cent of total incident mesothelioma cases. This same year, the NLCA switched from using a bespoke dataset to use the generic Cancer Outcomes and Services Dataset (COSD), linked to other National Cancer Registration and Analysis Service (NCRAS) registry datasets, as its primary data source. This dataset change has allowed data for all mesothelioma cases diagnosed during 2014, in England, to be analysed for the first time and reported here.
Methods:
Using 2014 COSD data submitted to the NLCA for all hospital trusts in England, we have analysed demographic, diagnostic and active treatment data items and in particular, have calculated the proportion of cases receiving histological subtype confirmation, palliative chemotherapy and per cent surviving to one year after diagnosis, both nationally and by strategic cancer network (SCN).
Results:
There were 2179 cases of pleural mesothelioma diagnosed in England in 2014. Histological confirmation of diagnosis was very high, but the proportion of mesothelioma cases without histological sub-classification (M9050/3) was 47%. This unspecified mesothelioma rate varied from 32.6 up to 74.4% by cancer network across England. Overall, palliative chemotherapy was given to 51% of patients with performance status (PS) 0-1, however at network level, this varied from 42.2% up to 77.4%. For all cases of mesothelioma, the 1 year overall survival was 43% with variation by network from 37.5 to 55.6% with adjusted odds ratios (OR) ranging from OR 0.8 up to 1.56.
Conclusion:
There has been improvement in the proportion of mesothelioma patients in England receiving histological subtyping compared to previous years and in the proportion of patients with good PS being treated with palliative chemotherapy. However, there is still marked variation across the country and addressing this may improve national outcomes further. Cancer networks and individual hospitals should examine their results and implement mechanisms to ensure best practice is being followed.
