Results of the Austrian National Lung Cancer Audit.,Clinical Medicine Insights: Oncology

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Results of the Austrian National Lung Cancer Audit.
Clinical Medicine Insights: Oncology ( IF 1.9 ) Pub Date : 2020-09-10 , DOI: 10.1177/1179554920950548
Otto C Burghuber _{1,

2} , Klaus Kirchbacher ₃ , Andrea Mohn-Staudner ₄ , Maximilian Hochmair ₁ , Marie-Kathrin Breyer ₄ , Michael Studnicka ₅ , Michael Rolf Mueller _{2,

6} , Petra Feurstein ₇ , Andrea Schrott ₁ , Bernd Lamprecht ₈ , Josef Eckmayr ₉ , Friedrich Renner ₁₀ , Josef Bolitschek _{11,

12} , Wolfgang Pohl ₁₃ , Peter Schenk ₁₄ , Peter Errhalt ₁₅ , Peter Cerkl ₁₆ , Bernhard Baumgartner ₁₇ , Meinhard Kneussl ₃ , Sylvia Hartl ₄

Affiliation

First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria.
Medical School, Sigmund Freud University, Vienna, Austria.
Second Medical Department with Pneumology, Wilhelminenspital, Vienna, Austria.
Second Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria.
Department of Pneumology, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg, Austria.
Department of Thoracic Surgery and Karl Landsteiner Institute for Thoracic Oncology, Otto Wagner Hospital, Vienna, Austria.
Department of Radio-Oncology, Wilhelminenspital, Vienna, Austria.
Department of Pneumology, General Hospital Linz, Linz, Austria.
Department of Pneumology, Klinikum Wels-Grieskirchen, Wels, Austria.
Department of Internal Medicine, Krankenhaus der Barmherzigen Schwestern Ried/Innkreis, Ried im Innkreis, Austria.
Department of Pneumology, Krankenhaus der Elisabethinen, Linz, Austria.
Department of Pneumology, Klinikum Steyr, Steyr, Austria.
Department of Pneumology and Respiratory Diseases, Krankenhaus Hietzing-Rosenhügel, Vienna, Austria.
Department of Pulmonology, Landesklinikum Hochegg, Hochegg, Austria.
Clinical Department of Pneumology, Landesklinikum Krems, Krems, Austria.
Department of Pulmonology, Landeskrankenhaus Hohenems, Hohenems, Austria.
Department of Pulmonology, Salzkammergut Klinikum Vöcklabruck, Vöcklabruck, Austria.

Objectives:

The Austrian Lung Cancer Audit (ALCA) is a pilot study to evaluate clinical and organizational factors related to lung cancer care across Austria.

Materials and methods:

The ALCA is a prospective, observational, noninterventional cohort study conducted in 17 departments in Austria between September 2013 and March 2015. Participating departments were selected based on an annual case load of >50 patients with lung cancer.

Results:

The ALCA included 745 patients, representing 50.5% of all newly diagnosed cancer cases during that time period. In 75.8% of patients, diagnosis was based on histology, and in 24.2% on cytology; 83.1% had non-small-cell lung cancer, 16.9% small-cell lung cancer; and only 4.6% had to be classified as not otherwise specified cancers. The median time elapsed between first presentation at hospital and diagnosis was 8 days (interquartile range [IQR]: 4-15; range: 0-132); between diagnosis and start of treatment it was 15 days for chemotherapy (IQR: 9-27; range: 0-83), 21 days (IQR: 10-35; range: 0-69) for radiotherapy, and 24 days (IQR: 11-36; range: 0-138) for surgery, respectively. In 150 patients undergoing surgical treatment, only 3 (2.0%; n = 147, 3 missings) were seen with postoperative restaging indicating unjustified surgery. One-year follow-up data were available for 723 patients, indicating excellent 49.8% survival; however, a wide range of survival between departments (range: 37.8-66.7) was seen.

Conclusions:

The ALCA conducted in high case load departments indicated management of lung cancer in accordance with international guidelines, and overall excellent 1-year survival.

中文翻译：

奥地利国家肺癌审计的结果。

目标：

奥地利肺癌审计 (ALCA) 是一项试点研究，旨在评估与奥地利肺癌护理相关的临床和组织因素。

材料和方法：

ALCA 是一项前瞻性、观察性、非干预性队列研究，于 2013 年 9 月至 2015 年 3 月期间在奥地利的 17 个科室进行。参与科室的选择基于每年超过 50 名肺癌患者的病例量。

结果：

ALCA 包括 745 名患者，占该时期所有新诊断癌症病例的 50.5%。在 75.8% 的患者中，诊断基于组织学，24.2% 的患者基于细胞学；83.1%为非小细胞肺癌，16.9%为小细胞肺癌；只有 4.6% 必须被归类为未指定的癌症。首次就诊到确诊之间的中位时间为 8 天（四分位距 [IQR]：4-15；范围：0-132）；从诊断到开始治疗，化疗间隔为 15 天（IQR：9-27；范围：0-83），放疗间隔为 21 天（IQR：10-35；范围：0-69），放疗间隔为 24 天（IQR： 11-36；范围：0-138) 分别用于手术。在接受手术治疗的 150 名患者中，只有 3 名（2.0%；n = 147，3 名缺失）出现术后再分期，表明手术不合理。723 名患者获得了一年的随访数据，显示出色的 49.8% 生存率；然而，看到了部门之间的广泛生存（范围：37.8-66.7）。