Prognosis for lung cancer patients dependent on adherence to treatment guidelines

Jan. 20, 2023

Treatment for lung cancer is rapidly evolving, with new technologies and research-proven procedures. However, a study from Washington University School of Medicine in St. Louis found the quality of care for lung cancer in the U.S. varies widely, with significantly worse outcomes among patients whose surgeries fall short of established treatment guidelines.

To help close the gap in the quality of care, the researchers examined five surgical quality metrics based on guidelines established by the National Comprehensive Cancer Network and other cancer groups, and found that adherence to these quality metrics was associated with improved overall survival rates. The study was published in JAMA Surgery

“It is crucial to have a solid understanding of what constitutes a high-quality lung cancer surgery,” said the study’s senior author, Varun Puri, MD, a Washington University thoracic surgeon, and professor of surgery who treats patients at Siteman Cancer Center, based at Barnes-Jewish Hospital and Washington University. “Improving adherence to surgical quality measures is critical to optimize long-term outcomes among patients with early-stage lung cancer seeking treatment intended to cure their cancer.” 

Lung cancer is the leading cause of cancer deaths in the United States and is the second most common type of cancer, with non-small cell lung cancer accounting for 84% of all lung cancer cases, according to the American Cancer Society. 

The five recommended quality metrics identified by researchers include performing surgery in a timely manner, shortly after diagnosis; determining the appropriate amount of lung tissue to be surgically removed; sampling multiple lymph nodes to confirm the cancer is staged correctly and has not spread to the lymph nodes; using minimally invasive surgery to reduce postsurgical pain and accelerate the recovery process; and ensuring that no cancer is left within the body, also known as a positive margin. 

“Ideally, these quality metrics should be met as frequently as possible in any lung cancer surgery,” Puri said. “However, as our data show, adherence to these metrics can be highly variable across the U.S.” 

Washington University School of Medicine release