2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.07D.02 Comprehensive Treatment Availability is Associated with Improved Outcomes Among Veterans with Early-Stage Lung Cancer Treated at VA Hospitals

EP.07D.02 Comprehensive Treatment Availability is Associated with Improved Outcomes Among Veterans with Early-Stage Lung Cancer Treated at VA Hospitals

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The study investigates the impact of comprehensive, multidisciplinary care on outcomes for Veterans with early-stage non-small cell lung cancer (NSCLC) within the Veterans Health Administration (VHA). This care typically involves either lung resection or stereotactic body radiotherapy (SBRT), with the VHA providing lung resections at approximately 100 sites, though fewer than half offer SBRT in-house. The research aimed to evaluate how variable access to SBRT affects patient outcomes among Veterans receiving care in the VHA from 2006 to 2016.<br /><br />This retrospective cohort study used VHA datasets and included adults treated in VA medical centers undergoing lung resections for early-stage NSCLC (tumors ≤5 cm, no lymph node involvement). The primary exposure evaluated was whether care was received at centers offering only surgery versus those providing comprehensive care, including both surgery and SBRT.<br /><br />Findings indicated that Veterans treated at centers with both thoracic surgery and SBRT experienced better short-term and long-term morbidity and mortality outcomes. Comprehensive centers demonstrated superior patient selection and operative quality, using process-based quality metrics like VALCAN-M for patient selection and VALCAN-O for operational procedures. The comprehensive centers had lower rates of major complications and decreased 30- and 90-day mortality rates.<br /><br />The study concluded that availability of comprehensive treatment options, including both surgery and SBRT, is associated with improved outcomes. These findings support recommendations to expand SBRT capabilities at all VA medical centers providing lung cancer care, suggesting that multidisciplinary approaches enhance treatment efficacy and patient outcomes. This work highlights the benefits of integrated cancer care systems within the VHA.

Asset Subtitle

Brendan Heiden

Meta Tag

Speaker Brendan Heiden

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

Veterans Health Administration

non-small cell lung cancer

multidisciplinary care

lung resection

stereotactic body radiotherapy

patient outcomes

comprehensive treatment

morbidity and mortality

integrated cancer care

VA medical centers