Personal and hospital factors associated with limited surgical resection for lung cancer, in-hospital mortality and complications in New York State.

ABSTRACT

BACKGROUND AND OBJECTIVES: Early stage lung cancer is generally treated with surgical resection. The objective of the study was to identify patient and hospital characteristics associated with the type of lung cancer surgical approach utilized in New York State (NYS), and to assess in-hospital adverse events. METHODS: A total of 33 960 lung cancer patients who underwent limited resection (LR) or lobectomy (L) were selected from the NYS Statewide Planning and Research Cooperative System database (1995-2012). RESULTS: LR patients were more likely to be older (adjusted odds ratio ORadj and [95% confidence interval] 1.01 [1.01-1.02]), female (ORadj 1.11 [1.06-1.16]), Black (ORadj 1.17 [1.08-1.27]), with comorbidities (ORadj 1.08 [1.03-1.14]), and treated in more recent years than L patients. Length of stay and complications were significantly less after LR than L (ORadj 0.56 [0.53-0.58] and 0.65 [0.62-0.69]); in-hospital mortality was similar (ORadj 0.93 [0.81-1.07]), and was positively associated with age and urgent/emergency admission, but inversely associated with female gender, private insurance, recent admission year, and surgery volume. CONCLUSIONS: There was a growing trend toward LR, which was more likely to be performed in older patients with comorbidities. In-hospital outcomes were better after LR than L, and were affected by patient and hospital characteristics.