Introduction

The optimal resection rate for Stage I-IIIa lung cancer is not known and there is marked heterogeneity in resection rates between districts. Single centre data suggests that the majority of technically resectable patients considered unfit for surgery, mortality was secondary to lung cancer progression rather than the comorbidities precluding surgery¹. This study evaluates the surgical resection rate at a regional Australian centre, the outcomes of early-stage lung cancer patients and factors predictive of resection.

Method

We reviewed the outcomes of early-stage lung cancer patients discussed at the lung cancer multidisciplinary team meeting at an Australian centre from 2018-2020. Data was extracted from medical records and included patient demographics, cancer stage, patient comorbidities and MDT outcome: resection vs alternative treatment, including reason for not proceeding to surgery.

Results

265 patients were discussed during the study period. 109 (41%) had Stage I-IIIa lung cancer. 38 patients underwent resection (14% of the overall cohort). 71 patients were not offered surgery due to co-morbidities 51 (72%), inoperability (5), recurrence (8), concurrent malignancy (3) declined surgery (2). At endpoint, 48 patients were deceased. In the non-resected group, the main cause of death was lung cancer progression (28), followed by co-morbidities (5). The median survival for non-resected patients was 1195 days while the median survival in the resected group couldn?t be calculated due to survival.

Conclusion 

The lung cancer resection rate was low and the most common cause of death in patients who did not undergo surgery was lung cancer progression rather than their comorbidities.

¹PMID: 34326151