Impact of distance from surgery department on the outcome of patients followed for non-small-cell lung cancer in the respiratory department of nonacademic hospitals: Results of the KBP-2010-study.

Autor:	Debieuvre D; Groupe hospitalier de la région Mulhouse Sud-Alsace, hôpital Émile-Muller, département de pneumologie, 68070 Mulhouse, France. Electronic address: debieuvred@ghrmsa.fr., Fraboulet G; Centre hospitalier René-Dubos, service d'oncohématologie, 95301 Cergy-Pontoise, France., Duvert B; Centre hospitalier de Montélimar, service oncologie, 26200 Montélimar, France., Piquet J; Centre hospitalier intercommunal Le Raincy-Montfermeil, service de pneumologie, 93370 Montfermeil, France., Goarant E; Centre hospitalier de Saint-Malo-hôpital Broussais, service de pneumologie, 35403 Saint-Malo, France., Sandron D; Centre hospitalier de Saint-Nazaire, service de pneumologie-oncologie-allergologie, 44606 Saint-Nazaire, France., Mouroux-Rotomondo C; Centre hospitalier d'Antibes-Juan-Les-Pins, service de pneumologie, 06600, France., Borrel B; Centre hospitalier Général d'Albi, service de pneumologie, 81013 Albi, France., Genety C; Centre hospitalier Les Charmes, service de pneumologie, 71600 Paray-Le-Monial, France., Kassem GJ; Centre hospitalier de Sedan, service de pneumologie, 08200 Sedan, France., Grivaux M; Centre hospitalier de Meaux, département de pneumologie, 77104 Meaux cedex, France.
Jazyk:	angličtina
Zdroj:	Bulletin du cancer [Bull Cancer] 2017 Oct; Vol. 104 (10), pp. 840-849. Date of Electronic Publication: 2017 Sep 29.
DOI:	10.1016/j.bulcan.2017.07.008
Abstrakt:	Objective: Increased postoperative mortality in low volume centers has contributed to merge and space thoracic surgical centers. Some studies have showed that the likelihood of receiving surgery was lower in lung cancer patients living far from a thoracic surgery center. Our objective was thus to determine whether surgery and survival rates in patients with non-small-cell lung cancer (NSCLC) were influenced by the distance between the respiratory and thoracic surgery departments. Methods: KBP-2010-CPHG is a prospective multicenter epidemiological study including 6083 patients followed in 104 nonacademic hospitals for primary NSCLC diagnosed in 2010. Distance between respiratory and thoracic surgery departments were obtained retrospectively. Predictive factors for surgery and mortality were identified by logistic regression and Cox hazard model. Results: Twenty-three percent of hospitals had a thoracic surgery department; otherwise, mean distance between the hospital and the surgery center was 65km. Nineteen percent of patients underwent surgery. Distance was neither an independent factor for surgery (odds-ratios [95% CI]: 0.971 [0.74-1.274], 0.883 [0.662-1.178], and 1.015 [0.783-1.317] for 1-34, 35-79, and ≥80km vs. 0km) nor for mortality (hazard-ratios [95% CI]: 1.020 [0.935-1.111], 1.003 [0.915-1.099], and 1.006 [0.927-1.091]) (P>0.05). Discussion: This result supports the French national strategy which merges surgery departments and should reassure patients (and physicians) who could be afraid to be lately addressed to surgery or loose chance when being followed far from the thoracic surgical center. (Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
Databáze:	MEDLINE
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