Survival rates of patients with stage 3A non-small cell lung cancer (NSCLC) who had undergone surgery increased more than 3-fold for those who received 4 quality measures as part of care, according to a study presented at the American Association for Thoracic Surgery Annual Meeting 2016 in Baltimore, MD.1

Pamela Samson, MD, MPHS, of Washington University in St. Louis, MO, analyzed data from the National Cancer Data Base (NCDB) in order to identify clinical stage 3A NSCLC patients who had undergone surgical resection from 2006 to 2011.

The database, which is a joint collaboration between the American College of Surgeons and the American Cancer Society, contains patient, tumor, and treatment data for about 70% of patients with cancer who received care at Commission on Cancer accredited centers.

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The researchers investigated 4 quality measures: neoadjuvant multi-agent chemotherapy, lobar (or greater) resection, sampling of at least 10 lymph nodes, and R0 resection.

Between 2006 to 2010, there were 54,069 patients with clinical stage3A NSCLC who had undergone surgical resection.

The study data showed that there was a benefit of including more quality measures into patient care. Overall median survival for patients who did not receive any measures began at 12.7 months, then increased to 25 months for those receiving 1 measure, 31.4 months for those receiving 2 measures, 36.6 months for those receiving 3 measures, and 43.5 months for those receiving all 4 measures.

Additionally, they found that private insurance or Medicare status, higher education, and receiving care at an academic cancer or high-volume surgical center were associated with an increased likelihood of receiving all 4 quality measures.

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“This analysis demonstrated that the majority of clinical stage 3A NSCLC patients are not receiving multi-agent induction chemotherapy prior to resection,” the authors noted. “This underscores the need for evaluation of the clinical stage 3A NSCLC patient by a multidisciplinary group.”


  1. Stage IIIA non-small cell lung cancer survival rates improved when care includes 4 specific quality measures [news release]. American Association for Thoracic Surgery. May 16, 2016. Accessed May 17, 2016.