Effect of surgical intervention on survival of patients with clinical N2 non-small cell lung cancer: A veterans' affairs central cancer registry (VACCR) database analysis

Apar K. Ganti, Wilson Gonsalves, Fausto R. Loberiza, Ibrahim Aldoss, Rishi Batra, Peter T. Silberstein, Shanmuga P. Subbiah, Anne Kessinger

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Optimal management of locally advanced non-small cell lung cancer (NSCLC) lacks consensus. A retrospective analysis of patient data entered in the Veterans Affairs Central Cancer Registry was conducted to evaluate these issues. Patients and Methods: Data of patients with cT1-4, cN2, and cM0 NSCLC diagnosed in the VA Health System between 1995 and 2003 were evaluated. Age, sex, race, smoking history, TNM stage, treatment, and overall survival were abstracted. Survival was compared using multivariate Cox proportional hazards regression analysis. Results: Of the 7328 patients analyzed, 7218 (98.5%) were male, 6061 (82.7%) were white, and 321 (4.4%) were never smokers. The treatment received included: none, 23.8%; chemotherapy alone, 14.3%; radiation alone, 23%; and chemoradiation (sequential or concurrent), 31.4%. Only 7.5% of patients had a surgical resection, with or without multimodality therapy. The median survival (months) of these patient groups were: surgery, 19.3; chemoradiation, 13; chemotherapy alone, 9.2; radiation alone, 7.3; and no treatment, 4 (P <0.0001). African Americans had a significantly decreased risk of mortality compared with whites (hazard ratio 0.92; 95% confidence interval, 0.87-0.98). Conclusions: Inclusion of surgical resection as a treatment modality was associated with a better overall survival. Also, African Americans appeared to do better than whites. These hypothesis-generating findings should be useful in the ongoing pursuit of better treatment strategies for locally advanced NSCLC.

Original languageEnglish
Pages (from-to)142-146
Number of pages5
JournalAmerican Journal of Clinical Oncology
Volume39
Issue number2
DOIs
StatePublished - 2016

Fingerprint

Veterans
Non-Small Cell Lung Carcinoma
Registries
Databases
Survival
Neoplasms
African Americans
Therapeutics
Radiation
Drug Therapy
Consensus
Smoking
History
Regression Analysis
Confidence Intervals
Mortality
Health

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research
  • Medicine(all)

Cite this

Effect of surgical intervention on survival of patients with clinical N2 non-small cell lung cancer : A veterans' affairs central cancer registry (VACCR) database analysis. / Ganti, Apar K.; Gonsalves, Wilson; Loberiza, Fausto R.; Aldoss, Ibrahim; Batra, Rishi; Silberstein, Peter T.; Subbiah, Shanmuga P.; Kessinger, Anne.

In: American Journal of Clinical Oncology, Vol. 39, No. 2, 2016, p. 142-146.

Research output: Contribution to journalArticle

Ganti, Apar K. ; Gonsalves, Wilson ; Loberiza, Fausto R. ; Aldoss, Ibrahim ; Batra, Rishi ; Silberstein, Peter T. ; Subbiah, Shanmuga P. ; Kessinger, Anne. / Effect of surgical intervention on survival of patients with clinical N2 non-small cell lung cancer : A veterans' affairs central cancer registry (VACCR) database analysis. In: American Journal of Clinical Oncology. 2016 ; Vol. 39, No. 2. pp. 142-146.
@article{b07352b6abaf427e99f8950148a8503e,
title = "Effect of surgical intervention on survival of patients with clinical N2 non-small cell lung cancer: A veterans' affairs central cancer registry (VACCR) database analysis",
abstract = "Background: Optimal management of locally advanced non-small cell lung cancer (NSCLC) lacks consensus. A retrospective analysis of patient data entered in the Veterans Affairs Central Cancer Registry was conducted to evaluate these issues. Patients and Methods: Data of patients with cT1-4, cN2, and cM0 NSCLC diagnosed in the VA Health System between 1995 and 2003 were evaluated. Age, sex, race, smoking history, TNM stage, treatment, and overall survival were abstracted. Survival was compared using multivariate Cox proportional hazards regression analysis. Results: Of the 7328 patients analyzed, 7218 (98.5{\%}) were male, 6061 (82.7{\%}) were white, and 321 (4.4{\%}) were never smokers. The treatment received included: none, 23.8{\%}; chemotherapy alone, 14.3{\%}; radiation alone, 23{\%}; and chemoradiation (sequential or concurrent), 31.4{\%}. Only 7.5{\%} of patients had a surgical resection, with or without multimodality therapy. The median survival (months) of these patient groups were: surgery, 19.3; chemoradiation, 13; chemotherapy alone, 9.2; radiation alone, 7.3; and no treatment, 4 (P <0.0001). African Americans had a significantly decreased risk of mortality compared with whites (hazard ratio 0.92; 95{\%} confidence interval, 0.87-0.98). Conclusions: Inclusion of surgical resection as a treatment modality was associated with a better overall survival. Also, African Americans appeared to do better than whites. These hypothesis-generating findings should be useful in the ongoing pursuit of better treatment strategies for locally advanced NSCLC.",
author = "Ganti, {Apar K.} and Wilson Gonsalves and Loberiza, {Fausto R.} and Ibrahim Aldoss and Rishi Batra and Silberstein, {Peter T.} and Subbiah, {Shanmuga P.} and Anne Kessinger",
year = "2016",
doi = "10.1097/COC.0000000000000040",
language = "English",
volume = "39",
pages = "142--146",
journal = "American Journal of Clinical Oncology",
issn = "0277-3732",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Effect of surgical intervention on survival of patients with clinical N2 non-small cell lung cancer

T2 - A veterans' affairs central cancer registry (VACCR) database analysis

AU - Ganti, Apar K.

AU - Gonsalves, Wilson

AU - Loberiza, Fausto R.

AU - Aldoss, Ibrahim

AU - Batra, Rishi

AU - Silberstein, Peter T.

AU - Subbiah, Shanmuga P.

AU - Kessinger, Anne

PY - 2016

Y1 - 2016

N2 - Background: Optimal management of locally advanced non-small cell lung cancer (NSCLC) lacks consensus. A retrospective analysis of patient data entered in the Veterans Affairs Central Cancer Registry was conducted to evaluate these issues. Patients and Methods: Data of patients with cT1-4, cN2, and cM0 NSCLC diagnosed in the VA Health System between 1995 and 2003 were evaluated. Age, sex, race, smoking history, TNM stage, treatment, and overall survival were abstracted. Survival was compared using multivariate Cox proportional hazards regression analysis. Results: Of the 7328 patients analyzed, 7218 (98.5%) were male, 6061 (82.7%) were white, and 321 (4.4%) were never smokers. The treatment received included: none, 23.8%; chemotherapy alone, 14.3%; radiation alone, 23%; and chemoradiation (sequential or concurrent), 31.4%. Only 7.5% of patients had a surgical resection, with or without multimodality therapy. The median survival (months) of these patient groups were: surgery, 19.3; chemoradiation, 13; chemotherapy alone, 9.2; radiation alone, 7.3; and no treatment, 4 (P <0.0001). African Americans had a significantly decreased risk of mortality compared with whites (hazard ratio 0.92; 95% confidence interval, 0.87-0.98). Conclusions: Inclusion of surgical resection as a treatment modality was associated with a better overall survival. Also, African Americans appeared to do better than whites. These hypothesis-generating findings should be useful in the ongoing pursuit of better treatment strategies for locally advanced NSCLC.

AB - Background: Optimal management of locally advanced non-small cell lung cancer (NSCLC) lacks consensus. A retrospective analysis of patient data entered in the Veterans Affairs Central Cancer Registry was conducted to evaluate these issues. Patients and Methods: Data of patients with cT1-4, cN2, and cM0 NSCLC diagnosed in the VA Health System between 1995 and 2003 were evaluated. Age, sex, race, smoking history, TNM stage, treatment, and overall survival were abstracted. Survival was compared using multivariate Cox proportional hazards regression analysis. Results: Of the 7328 patients analyzed, 7218 (98.5%) were male, 6061 (82.7%) were white, and 321 (4.4%) were never smokers. The treatment received included: none, 23.8%; chemotherapy alone, 14.3%; radiation alone, 23%; and chemoradiation (sequential or concurrent), 31.4%. Only 7.5% of patients had a surgical resection, with or without multimodality therapy. The median survival (months) of these patient groups were: surgery, 19.3; chemoradiation, 13; chemotherapy alone, 9.2; radiation alone, 7.3; and no treatment, 4 (P <0.0001). African Americans had a significantly decreased risk of mortality compared with whites (hazard ratio 0.92; 95% confidence interval, 0.87-0.98). Conclusions: Inclusion of surgical resection as a treatment modality was associated with a better overall survival. Also, African Americans appeared to do better than whites. These hypothesis-generating findings should be useful in the ongoing pursuit of better treatment strategies for locally advanced NSCLC.

UR - http://www.scopus.com/inward/record.url?scp=84893184959&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893184959&partnerID=8YFLogxK

U2 - 10.1097/COC.0000000000000040

DO - 10.1097/COC.0000000000000040

M3 - Article

C2 - 24487419

AN - SCOPUS:84893184959

VL - 39

SP - 142

EP - 146

JO - American Journal of Clinical Oncology

JF - American Journal of Clinical Oncology

SN - 0277-3732

IS - 2

ER -