MedicalResearch.com Interview with:
Raymond U. Osarogiagbon, MBBS, FACP
Translational Lung Cancer Research
Multidisciplinary Thoracic Oncology Program
Baptist Centers for Cancer Care
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Most long-term survivors of lung cancer are among the patients who were fortunate enough to be identified early enough to undergo curative-intent surgery. In the US, 60,000 individuals undergo curative-intent surgery for lung cancer every year. This number is likely to increase over the next few years as lung cancer screening becomes more widely adopted. Unfortunately, fewer than 50% of patients who undergo curative-intent surgery actually survive up to 5 years.
We show that the quality of surgery, especially the quality of pathologic nodal staging is a powerful driver of survival differences between groups of patients. In general, pathologic nodal staging (important as it is stratifying patients into risk groups so those at high risk can be offered additional treatments to increase the chances of cure while those at truly low risk can be left alone without exposure to cost and side-effects of additional treatments) is very poorly done. We show how the percentage of patients whose pathologic staging met sequentially more stringently-define thoroughness of staging metrics falls off sharply, while the survival sequentially increases.
MedicalResearch.com: What should readers take away from your report?
Response: The quality of pathologic nodal staging of potentially curable lung cancer is generally poor; needs significant improvement. This improvement promises to improve population-level lung cancer survival.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: All future work to modify the Tumor Node Metastasis (TNM) staging system, which remains the most powerful prognostic tool in lung cancer must consider the quality of nodal staging. Significant additional research is needed to understand why staging quality is so poor, and how to improve it to a generally higher level.
MedicalResearch.com: Is there anything else you would like to add?
Response: These findings are probably also applicable beyond lung cancer, to all solid malignancies for which surgery and adjuvant therapy are a component of treatment.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation: Smeltzer MP, Faris NR, Ray MA, Osarogiagbon RU. Association of Pathologic Nodal Staging Quality With Survival Among Patients With Non–Small Cell Lung Cancer After Resection With Curative Intent. JAMA Oncol.Published online September 28, 2017. doi:10.1001/jamaoncol.2017.2993
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