Clinical Staging of Stage I Non-Small Cell Lung Cancer in the Netherlands—Need for Improvement in an Era With Expanding Nonsurgical Treatment Options: Data From the Dutch Lung Surgery Audit

Abstract

Concordance between clinical and pathologic stage is 59.9%. In patients with clinical stage I NSCLC, 22.6% were upstaged to pathologic stage II or higher, which is an indication for adjuvant chemotherapy. Improvement in accuracy of staging is thus needed, particularly for these patients.

Survival After Stereotactic Body Radiation Therapy for Clinically Diagnosed or Biopsy-Proven Early-Stage NSCLC: A Systematic Review and Meta-Analysis

“…Moreover, if nonsurgical therapies for NSCLC are to be considered for patients who are at low-risk for pulmonary resection, there is risk of understaging and subsequent undertreatment. 10 Physicians should inform patients about these issues with patients before treatment.…”

“…The Dutch Lung Surgery Audit showed that the concordance between clinical TNM and pathologic TNM was only 59.9% for patients with clinical stage I NSCLC who underwent surgical resection. 10 The net impact of the lack of pathologic confirmation and staging on reported survival after SBRT is not clarified. Whereas some authors believe the results are not impacted significantly, inclusion of nonmalignancies in cohort studies could obviously overestimate survival.…”

Consensus minimum data set for lung cancer multidisciplinary teams: Results of a Delphi process

“…This data set results from a practical approach to identify clinically useful data elements that facilitate standardization of MDT data collection, internal MDT review and future outcomes research. database, 12 the National Lung Cancer Audit (NLCA) key data items, 13 the Dutch lung surgery audit 14,15 and Can-cerLinQ 16 as well as registry data sets including the Victorian Lung Cancer Registry (VLCR) 17 and the Danish Lung Cancer Registry (DLCR). 18 These data sets are high quality and capture crucial information on case-mix variables and population-based outcomes.…”

“…Data sources that provide information on the impact of MDT care include state cancer registries, local cancer registries, hospital‐based registries and (via linkage) national administrative data sets . There are many different data sources and collection strategies for lung cancer, including the International Consortium for Health Outcomes (ICHOM) database, the National Lung Cancer Audit (NLCA) key data items, the Dutch lung surgery audit and CancerLinQ as well as registry data sets including the Victorian Lung Cancer Registry (VLCR) and the Danish Lung Cancer Registry (DLCR) . These data sets are high quality and capture crucial information on case‐mix variables and population‐based outcomes.…”

Kwaliteitsregistraties volgens het principe van ‘clinical auditing’

“…De longkankeraudit (DLCA) laat zien dat in Nederland slechts 55 % van de chirurgische patiënten klinisch correct gestadieerd wordt en respectievelijk 30 en 15 % onder-en overgestadieerd [19]. Als consequentie daarvan krijgen patiënten mogelijk niet altijd de behandeling die optimaal is voor hun daadwerkelijke ziektestadium [24].…”