Trend of lung cancer surgery, hospital selection, and survival between 2005 and 2016 in South Korea

Abstract

Background Studies on the clinical implication of hospital selection for patients with lung cancer are few. Therefore, this study aimed to analyze 2005–2016 data from the Korean national database to assess annual trends of lung cancer surgery and clinical outcomes according to hospital selection. Methods Data of 212 554 patients with lung cancer who underwent upfront surgery were screened. Trends according to sex, age, residence, and income were examined. Descriptive statistics were performed, and ptrend values were estimated. The association between survival and hospital selection was assessed using the log‐rank test. A multivariate Cox regression analysis was also performed. Results A total of 49 021 patients were included in this study. Surgery was prevalent among men, patients aged 61–75 years, capital area residents, and high‐income patients. However, with the increasing rate of surgery among women, patients aged ≥76 years, city residents, and middle‐income patients, the current distribution of lung cancer surgery could change. The rate of lobectomy among these groups increased. All patients, except those in capital areas, preferred a hospital outside their area of residence (HOR); the number of patients with this tendency also increased. However, this trend was not observed among low‐income patients and those aged ≥76 years. There were significant differences in survival according to hospital selection. Conclusions The trend of lung cancer surgery is changing. The current medical system is effective in providing lobectomy for patients including women, aged ≥76 years, city residents, and middle‐income. Increasing tendency to choose an HOR requires further study.

The Uncomfortable Truth: Open Thoracotomy versus Minimally Invasive Surgery in Lung Cancer: A Systematic Review and Meta-Analysis

“…The development of thoracic oncologic surgery has progressed from more to less invasive techniques [1]. For example, in the case of lung cancer, the standard extent of removal has shifted from pneumonectomy or bilobectomy to lobectomy or segmentectomy [2,3]. As for the approach or incisions, they were from full thoracotomy, anterolateral, or posterolateral thoracotomy to video-assisted thoracic surgery (VATS) or robot-assisted thoracic surgery (RATS) [4].…”

Assessment of textbook outcome after lobectomy for early‐stage non‐small cell lung cancer in a Korean institution: A retrospective study

“…The total number of lung cancer surgeries performed has increased over time in Korea. However, the number of extensive resections, such as bilobectomy or pneumonectomy, has decreased 4,5 . This trend may be associated with the increased use of computed tomography (CT), which results in more lung cancer detected in earlier stages, indicating less extensive surgical treatment.…”

“…However, the number of extensive resections, such as bilobectomy or pneumonectomy, has decreased. 4 , 5 This trend may be associated with the increased use of computed tomography (CT), which results in more lung cancer detected in earlier stages, indicating less extensive surgical treatment. Early detection and increased use of surgical treatment may be related to recent improvements in the prognosis of lung cancer in Korea, 6 and this trend may continue in the future with the increased use of low‐dose chest CT as a lung cancer screening program.…”

How to determine surgical management in octogenarian patients with lung cancer?

“…Despite these limitations, this paper should be noted for the following reasons. First, the authors made efforts to find appropriate surgical indications in a vulnerable elderly group (octogenarians) using the reliable SEER database ( 18 ). As the number of elderly individuals continues to increase in many countries, and surgery for the elderly remains minimal, this could be a reliable resource for the societies entering an aged population ( 19 , 20 ).…”