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The effect of emergency presentation on surgery and survival in lung cancer patients in England, 2006–2008

Tataru, Daniela; Jack, Ruth H.; Lind, Michael J.; Møller, Henrik; Lüchtenborg, Margreet

Authors

Daniela Tataru

Ruth H. Jack

Professor Michael Lind M.J.Lind@hull.ac.uk
Foundation Professor of Oncology/ Head of the Joint Centre for Cancer Studies

Henrik Møller

Margreet Lüchtenborg



Abstract

A large proportion of lung cancer patients in England are diagnosed through an emergency route, which is associated with poorer outcomes. Here, we investigated the association between emergency presentation and the odds of undergoing surgical resection and subsequent survival among lung cancer patients undergoing surgical resection as well as those who did not. Methods: Details of 93,783 lung cancers were extracted from the National Cancer Data Repository. For non-small cell lung cancer (NSCLC) patients we calculated odds ratios for undergoing surgical resection. Survival was assessed for resected NSCLC and for all other lung cancer patients in three different time intervals: short-term, intermediate and long-term. Results: Compared with those who did not, NSCLC patients presenting through an emergency route were less likely to undergo surgical resection (adjusted OR=0.22, 95% CI: 0.20-0.24). Patients who underwent surgical resection after an emergency presentation had lower survival in the intermediate period (adjusted HR=1.27, 95% CI: 1.06-1.54) and long term (adjusted HR=1.20, 95% CI: 0.99-1.45). Among all other lung cancer patients, those diagnosed through an emergency route had lower survival, particularly in the short-term (adjusted HR=3.54, 95% CI: 3.42-3.67), but the association remained in the intermediate (adjusted HR=1.66, 95% CI: 1.63-1.69) and long term (adjusted HR=1.10, 95% CI: 1.05-1.15). Conclusion: The reduced access to surgical resection and lower survival among lung cancer patients who present through an emergency admission, highlights the importance of ensuring symptoms are recognised early so that presentation as an emergency can be red uced.

Journal Article Type Article
Publication Date 2015-08
Journal Cancer Epidemiology
Print ISSN 1877-7821
Electronic ISSN 1877-783X
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 39
Issue 4
Pages 612-616
APA6 Citation Tataru, D., Jack, R. H., Lind, M. J., Møller, H., & Lüchtenborg, M. (2015). The effect of emergency presentation on surgery and survival in lung cancer patients in England, 2006–2008. Cancer epidemiology, 39(4), (612-616). doi:10.1016/j.canep.2015.04.008. ISSN 1877-7821
DOI https://doi.org/10.1016/j.canep.2015.04.008
Keywords Cancer Research; Epidemiology; Oncology
Publisher URL http://www.sciencedirect.com/science/article/pii/S1877782115000909?via%3Dihub#!
Additional Information This article is maintained by: Elsevier; Article Title: The effect of emergency presentation on surgery and survival in lung cancer patients in England, 2006–2008; Journal Title: Cancer Epidemiology; CrossRef DOI link to publisher maintained version: http://dx.doi.org/10.1016/j.canep.2015.04.008; Content Type: article; Copyright: Crown copyright © 2015 Published by Elsevier Ltd. All rights reserved.
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