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dc.contributor.authorLawrenson, Rossen_NZ
dc.contributor.authorLao, Chunhuanen_NZ
dc.contributor.authorBrown, Leonieen_NZ
dc.contributor.authorMoosa, Luciaen_NZ
dc.contributor.authorChepulis, Lynne Merranen_NZ
dc.contributor.authorKeenan, Rawirien_NZ
dc.contributor.authorKidd, Jacquieen_NZ
dc.contributor.authorMiddleton, Karenen_NZ
dc.contributor.authorConaglen, Paulen_NZ
dc.contributor.authorde Groot, Charlesen_NZ
dc.contributor.authorAitken, Deniseen_NZ
dc.contributor.authorWong, Janiceen_NZ
dc.coverage.spatialEnglanden_NZ
dc.date.accessioned2020-03-03T20:47:08Z
dc.date.available2020-02-10en_NZ
dc.date.available2020-03-03T20:47:08Z
dc.date.issued2020en_NZ
dc.identifier.citationLawrenson, R., Lao, C., Brown, L., Moosa, L., Chepulis, L., Keenan, R., … Wong, J. (2020). Management of patients with early stage lung cancer - why do some patients not receive treatment with curative intent? BMC Cancer, 20(1), 109. https://doi.org/10.1186/s12885-020-6580-6en
dc.identifier.urihttps://hdl.handle.net/10289/13484
dc.description.abstractBACKGROUNDS: This study aims to understand the factors that influence whether patients receive potentially curative treatment for early stage lung cancer. A key question was whether indigenous Māori patients were less likely to receive treatment. METHODS: Patients included those diagnosed with early stage lung cancer in 2011-2018 and resident in the New Zealand Midland Cancer Network region. Logistic regression model was used to estimate the odds ratios of having curative surgery/ treatment. The Kaplan Meier method was used to examine the all-cause survival and Cox proportional hazard model was used to estimate the hazard ratio of death. RESULTS: In total 419/583 (71.9%) of patients with Stage I and II disease were treated with curative intent - 272 (46.7%) patients had curative surgery. Patients not receiving potentially curative treatment were older, were less likely to have non-small cell lung cancer (NSCLC), had poorer lung function and were more likely to have an ECOG performance status of 2+. Current smokers were less likely to be treated with surgery and more likely to receive treatment with radiotherapy and chemotherapy. Those who were treated with surgery had a 2-year survival of 87.8% (95% CI: 83.8-91.8%) and 5-year survival of 69.6% (95% CI: 63.2-76.0%). Stereotactic ablative body radiotherapy (SABR) has equivalent effect on survival compared to curative surgery (hazard ratio: 0.77, 95% CI: 0.37-1.61). After adjustment we could find no difference in treatment and survival between Māori and non-Māori. CONCLUSIONS: The majority of patients with stage I and II lung cancer are managed with potentially curative treatment - mainly surgery and increasingly with SABR. The outcomes of those being diagnosed with stage I and II disease and receiving treatment is positive with 70% surviving 5 years.en_NZ
dc.format.mimetypeapplication/pdf
dc.language.isoenen_NZ
dc.rights© The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.subjectLung canceren_NZ
dc.subjectNon-small cell lung canceren_NZ
dc.subjectSmokingen_NZ
dc.subjectStereotactic ablative body radiotherapyen_NZ
dc.subjectThoracic surgeryen_NZ
dc.titleManagement of patients with early stage lung cancer - why do some patients not receive treatment with curative intent?en_NZ
dc.typeJournal Article
dc.identifier.doi10.1186/s12885-020-6580-6en_NZ
dc.relation.isPartOfBMC Canceren_NZ
pubs.begin-page109
pubs.elements-id250830
pubs.issue1en_NZ
pubs.publication-statusPublished onlineen_NZ
pubs.volume20en_NZ
dc.identifier.eissn1471-2407en_NZ


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