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Christina Pinkston

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    P1.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 947)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.15-02 - Migration Differences in Small Cell vs Non-Small Cell Lung Cancer (ID 13035)

      16:45 - 18:00  |  Author(s): Christina Pinkston

      • Abstract
      • Slides


      Every year there is a population diagnosed with lung cancer (LC) that does not receive initial treatment upon diagnosis and then “migrates” to other hospital systems before ultimately getting treatment. We aimed to compare migration rates between non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) and potential factors associated with migration.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      As part of the Kentucky Lung Cancer Education Awareness Detection Survival (LEADS) Collaborative, 29 of 32 Kentucky hospital registries contacted provided LC data of 7660 patients from 2012-2014. Data collected included age at diagnosis, stage, overall survival (OS), sex, race, insurance and treatment history. Treatment included any combination of surgery, radiation, or chemotherapy. Hospital records were matched to Kentucky Cancer Registry records to determine the number of hospitals visited for treatment. Patient treatment and migration patterns were analyzed with a logistic regression model along with additional post-hoc analysis. Difference in rates was calculated by chi-square test.

      4c3880bb027f159e801041b1021e88e8 Result

      Among the 7660 LC patients, 81% were NSCLC and 19% were SCLC. Most patients were treated at their initial hospital - NSCLC (73%) and SCLC (82%) (p value<0.01). However, among the untreated patients, 616 (36%) of NSCLC patients migrated to a different hospital compared to only 23 (8%) of SCLC patients (p value<0.01). Migration of NSCLC patients to another hospital was associated with Stage I-III disease, younger age (66.4 vs 72.2 years), with initial hospitals missing treatment modalities and patients having private insurance. In NSCLC, compared to patients treated initially, patients treated after migration lived longer (591 vs 505 days) and particularly had longer survival with stage III (563 vs 495 days) and IV disease (379 vs 300 days). Too few patients with SCLC migrate to assess association with OS and other patient characteristics.

      8eea62084ca7e541d918e823422bd82e Conclusion

      There is a significant difference in rates of initial treatment between NSCLC and SCLC that could be due to perceived urgency to treat SCLC. This analysis shows highly significant 4-fold increase in migration rate of NSCLC as compared to SCLC. This could be explained by newer and better treatment options available at referral centers for NSCLC and a lack of these options for SCLC. Increasing research and new innovations in NSCLC will likely drive more patients to migrate in future.


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