Academic vs. Community-Based Centers: Survival Disparities Among Patients With NSCLC?
Posted: Wednesday, January 23, 2019
Patients with non–small cell lung cancer (NSCLC) treated in academic centers may have a survival advantage compared with those treated in community-based centers, according to a report published in the Journal of Thoracic Oncology. The study noted an overall histology-dependent survival difference between patients with adenocarcinoma and those with squamous cell carcinoma, which also seemed to vary by treatment facility.
“Given [the] known advances in adenocarcinoma treatment compared with squamous cell lung cancer over this time period, our study suggests potential treatment-related disparities may exist between academic centers and community centers,” Sendhilnathan Ramalingam, MD, and colleagues, at Duke University, Durham, North Carolina, concluded.
Using data from the National Cancer Database, the authors retrospectively analyzed 2-year survival rates in more than 193,000 patients with clinical or pathologic metastatic NSCLC following the introduction of chemotherapy agents between 1998 and 2010. Compared with community-based centers, in the academic centers, there was a higher percentage of black patients (17.1% vs. 9.6%) and a lower percentage of patients insured by Medicare (37.4% vs. 47.9%).
In 1998, 2-year survival rates were higher in academic centers than community-based centers—11.5% versus 9.2%—and by 2010, the rates increased to 17.4% and 13.1%, respectively. The authors also observed higher rates of survival among those with adenocarcinoma versus squamous cell carcinoma, and differences varied by treatment center. For example, between 1998 and 2010, survival rates increased from 10.2% to 17.3% among patients with adenocarcinoma, whereas the rates increased from 9.9% to 10.2% among those with squamous cell carcinoma. Patients with adenocarcinoma treated in academic centers achieved greater increases in 2-year survival rates between 1998 and 2010 (12.3% to 20.5%) compared with those treated in community-based centers (9.1% to 15.5%).
Disclosure: The study authors’ disclosures can be found at jto.org.
