His team concluded that their findings represented an opportunity to improve the thoroughness, accuracy, and speed of preoperative evaluation of potential lung care patients, and noted that these benchmarks may be significantly improved with better coordination of care.

“Early involvement of all the key specialists involved in lung cancer care, adopting a strategic approach to sequential decision-making, actively involving patients and home caregivers in these strategic plans, and ensuring these decisions about optimal evidence-based care are executed in practice significantly shortens time from initial lesion to diagnosis, staging, and treatment, and increases the appropriate use of tests and appropriate treatment selection,” said Dr. Osarogiagbon.

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“The bottom line is that interdisciplinary decision-making, rigorous data-collection and analysis, and program benchmarking are all necessary to improve the quality of lung cancer care.”

Farhood Farjah, MD, MPH, of the University of Washington in Seattle, WA, provided an invited commentary in the same issue of The Annals.

He wrote that the authors’ findings “mirror those revealed through analyses of national cancer care registries—there are significant gaps in the quality of lung cancer care.” Dr. Farjah also emphasized the importance of the authors’ intention to use a disease-based, rather than treatment-based, approach to quality improvement.

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Dr. Osarogiagbon said, “treatment-based approaches look at only one segment of the full spectrum of treatment options, and try to analyze how to improve that narrow sliver of options, without understanding how patients flow into that track and where they leak out of the pipeline to that track.”

His team is continuing their research in an ongoing “Lung Cancer Milestones Phase II” analysis, which they intend to present in a few years.


  1. Faris N, Yu X, Sareen S, et al. Preoperative evaluation of lung care in a community health care setting. Ann Thorac Surg. 2015;100(2):394-400.
  2. National Cancer Institute. SEER stat fact sheets: lung and bronchus cancer. Available at: http://seer.cancer.gov/statfacts/html/lungb.html. Accessed August 9, 2015.
  3. Pfannschmidt J, Muley T, Bulzebruck H, Hoffman H, Dienemann H. Prognostic assessment after surgical resection for non-small lung cancer: experiences in 2083 patients. Lung Cancer. 2007;55(3): 371-377.