For patients with early-stage and advanced-stage non-small-cell lung cancer (NSCLC) with pre-existing chronic obstructive pulmonary disease (COPD), pulmonologist management is positively associated with rates of stage-specific treatment, according to a study published in the Annals of the American Thoracic Society.

Janaki A. Deepak, M.D., from the University of Maryland School of Medicine in Baltimore, and colleagues examined the correlation between pulmonologist management and the probability of receiving the recommended stage-specific treatment modality for patients with NSCLC and pre-existing COPD.

Data were included for 5,488 patients with early-stage and 6,426 patients with advanced-stage NSCLC diagnosed between 2002 and 2005 with a prior COPD diagnosis.

The researchers found that 54.9 percent of patients with early-stage and 35.7 percent of those with advanced-stage NSCLC had pulmonologist management.

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Of those with pulmonologist involvement, 58.5 percent of those with early-stage disease underwent surgical resection, while chemotherapy was received by 43.6 percent of those with advanced disease.

Post-NSCLC diagnosis, pulmonologist management correlated with increased rates of surgical resection (odds ratio, 1.26) for early NSCLC and with increased chemotherapy rates in advanced disease (odds ratio, 1.88).

For early-stage, but not advanced NSCLC patients, pulmonologist management correlated with reduced mortality risk.

“These results provide preliminary support for the recently published guidelines emphasizing the role of pulmonologists in lung cancer management,” the authors write.

Reference

  1. “Pulmonologist Involvement, Stage-Specific Treatment, and Survival in Adults with Non-Small Cell Lung Cancer and COPD.” Annals ATS. First published online March 11, 2015 as doi:10.1513/AnnalsATS.201406-230OC