Our Summary

This study uses data from the Dutch Lung Cancer Audit for Surgery to investigate the importance of adjusting for case mix (a mix of patient and disease characteristics) when comparing hospital outcomes for non-small cell lung cancer surgery. The researchers looked at factors associated with death within 30 days after surgery and complications from the surgery.

They found that the factors significantly predicting both of these outcomes included age, medical condition before surgery, cancer stage, lung function, extent of surgery, and postoperative findings. They also found a considerable variation in these factors between different hospitals.

In layman’s terms, this means that the mix of patient cases each hospital handles is different, which can skew comparisons of patient outcomes between hospitals. Therefore, it’s important to take into account these differences when comparing hospital performance on lung cancer surgery outcomes.

The results emphasize that simply comparing raw data may not give an accurate picture of how well different hospitals are doing; instead, the characteristics of the patients and their diseases need to be considered for a fair comparison.

FAQs

  1. What factors were found to significantly predict outcomes of non-small cell lung cancer surgery?
  2. Why is it important to adjust for case mix when comparing hospital outcomes for lung cancer surgery?
  3. How does the mix of patient cases at different hospitals affect comparisons of patient outcomes?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lung surgery is to make sure to follow all pre-operative instructions provided by your healthcare team. This may include quitting smoking, maintaining a healthy diet, staying active, and taking any prescribed medications as directed. By following these instructions, you can help ensure a successful surgery and a smoother recovery process.

Suitable For

Patients who are typically recommended for lung surgery include those with non-small cell lung cancer who are fit for surgery, have early-stage disease, good lung function, and are medically stable. Other factors that may influence the recommendation for lung surgery include the patient’s age, overall health, extent of the cancer, and the potential benefits and risks of surgery. Patients with advanced-stage lung cancer or significant medical comorbidities may not be considered suitable candidates for surgery. Ultimately, the decision to recommend lung surgery is made on a case-by-case basis by a multidisciplinary team of healthcare providers.

Timeline

Before lung surgery:

  • Patient is diagnosed with non-small cell lung cancer
  • Patient undergoes preoperative evaluations, such as imaging tests and lung function tests
  • Patient discusses treatment options with their healthcare team
  • Surgery is scheduled and patient prepares for the procedure

After lung surgery:

  • Patient undergoes surgery to remove part or all of the lung affected by cancer
  • Patient is monitored in the intensive care unit or recovery room
  • Patient may experience pain, discomfort, and limited mobility
  • Patient undergoes follow-up appointments and tests to monitor recovery and check for any complications
  • Patient may undergo additional treatments, such as chemotherapy or radiation therapy, depending on the stage of cancer and the success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung surgery include:

  1. What are the potential risks and complications associated with the surgery?
  2. How will my age, medical condition, cancer stage, and lung function affect the success of the surgery?
  3. What is the extent of the surgery that will be performed, and what are the expected outcomes?
  4. How will postoperative findings be monitored and managed?
  5. How does the hospital’s experience and track record with lung cancer surgery compare to others?
  6. Are there any alternative treatment options available?
  7. What is the recovery process like, and what kind of support will be provided post-surgery?
  8. What can I do to prepare for the surgery and improve my chances of a successful outcome?
  9. How will my care be coordinated between different healthcare providers throughout the treatment process?
  10. Are there any specific questions or concerns I should discuss with other members of the healthcare team, such as a pulmonologist or oncologist?

Reference

Authors: Beck N, Hoeijmakers F, van der Willik EM, Heineman DJ, Braun J, Tollenaar RAEM, Schreurs WH, Wouters MWJM. Journal: Ann Thorac Surg. 2018 Aug;106(2):412-420. doi: 10.1016/j.athoracsur.2018.02.074. Epub 2018 Apr 3. PMID: 29625100