Dataset Information

Social determinants and facility type impact adherence to best practices in operable IIIAN2 lung cancer.

ABSTRACT:

Objectives

We aimed to identify patient- and facility-specific predictors of collective adherence to 4 recommended best treatment practices in operable IIIAN2 non-small-cell lung cancer (NSCLC) and test the hypothesis that collective adherence is associated with superior survival.

Methods

We queried the National Cancer Database for clinical stage IIIAN2 NSCLC patients undergoing surgery during 2010-2015. The following best practices were examined: performance of an anatomic resection, performance of an R0 resection, examination of regional lymph nodes and administration of induction therapy. Multivariable regression models were fitted to identify independent predictors of guideline-concordance.

Results

We identified 7371 patients undergoing surgical resection for IIIAN2 lung cancer, of whom 90.8% underwent an anatomic resection, 88.2% received an R0 resection, 92.5% underwent a regional lymph node examination, 41.6% received induction therapy and 33.7% received all 4 best practices. Higher income, private insurance and treatment at an academic facility were independently associated with adherence to all 4 best practices (P < 0.01). A lower level of education and residence in a rural county were associated with a lack of adherence (P < 0.05). Adherence to all 4 practices correlated with improved survival (P < 0.01).

Conclusions

National adherence to best treatment practices in operable IIIAN2 lung cancer was variable as evidenced by the majority of patients not receiving recommended induction therapy. Socioeconomic factors and facility type are important determinants of guideline-concordance. Future efforts to improve outcomes should take this into account since guideline concordance, in the form of collective adherence to all 4 best practices, was associated with improved survival.

SUBMITTER: Muslim Z

PROVIDER: S-EPMC8923383 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

Social determinants and facility type impact adherence to best practices in operable IIIAN2 lung cancer.

Muslim Zaid Z Stroever Stephanie S Baig Mirza Zain MZ Weber Joanna F JF Connery Cliff P CP Bhora Faiz Y FY

Interactive cardiovascular and thoracic surgery 20210819 1

<h4>Objectives</h4>We aimed to identify patient- and facility-specific predictors of collective adherence to 4 recommended best treatment practices in operable IIIAN2 non-small-cell lung cancer (NSCLC) and test the hypothesis that collective adherence is associated with superior survival.<h4>Methods</h4>We queried the National Cancer Database for clinical stage IIIAN2 NSCLC patients undergoing surgery during 2010-2015. The following best practices were examined: performance of an anatomic resect ...[more]

PMID: 34999793

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Dataset Information

Social determinants and facility type impact adherence to best practices in operable IIIAN2 lung cancer.

Objectives

Methods

Results

Conclusions

Publications

Social determinants and facility type impact adherence to best practices in operable IIIAN2 lung cancer.

Similar Datasets

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