Effectiveness of Implemented Interventions on Pathologic Nodal Staging of Non-Small Cell Lung Cancer
| Autor: | David M. Spencer, Matthew P. Smeltzer, Vishal Sachdev, Todd Robbins, P. Levy, Carrie Fehnel, Raymond U. Osarogiagbon, Nicholas Faris, Cheryl Houston-Harris, Lynn Wiggins, Meredith Ray |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry 030204 cardiovascular system & hematology medicine.disease Article 03 medical and health sciences Dissection 0302 clinical medicine medicine.anatomical_structure Specimen collection 030220 oncology & carcinogenesis medicine Carcinoma Surgery Radiology Stage (cooking) Cardiology and Cardiovascular Medicine business Prospective cohort study Lung cancer Lymph node Survival rate |
| Popis: | BACKGROUND: Accurate pathologic nodal staging improves early-stage non-small-cell lung cancer survival. In an ongoing implementation study, we measured the impact of a surgical lymph node specimen collection kit and a more thorough pathologic gross dissection method, on attainment of guideline-recommended pathologic nodal staging quality. METHODS: We prospectively collected data on curative-intent non-small cell lung cancer resections from 2009–2016 from 11 hospitals in 4 contiguous Dartmouth Hospital Referral Regions. We categorized patients into 4 groups based on exposure to the two interventions in our staggered implementation study design. We used Chi-squared tests to examine the differences in demographic and disease characteristics and surgical quality criteria across implementation groups. RESULTS: Of 2,469 patients, 1,615 (65%) received neither intervention; 167 (7%) received only the pathology intervention; 264 (11%) received only the surgery intervention; 423 (17%) had both. Rates of non-examination of lymph nodes reduced sequentially in the order of no intervention, novel dissection, kit, and combined interventions, including non-examination of: any lymph nodes, hilar/intrapulmonary and mediastinal nodes (p |
| Databáze: | OpenAIRE |
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