Regional variation in lung cancer presentation, tumor type and tumor burden

Title: Regional variation in lung cancer presentation, tumor type and tumor burden
Author(s): W Shah,Q Ghaith, A Fabre, B Canavan,C McCarthy, D Healy,A Jouida M. P. Keane.
Institution: St Vincents university Hospital
Poster: Click to view poster
Category: Lung Cancer/CF/ILD/Surgery
Abstract: Lung cancer is a leading cause of death worldwide. As regional variation in cancer outcomes is undesirable, understanding the reasons for such is essential to improve care.
A retrospective analysis was performed of 584 patients diagnosed with primary lung cancer at the NCCP MDT at St Vincent's University Hospital from 2016-2020. Stage at diagnosis, lymph nodes status, tumour size post resection and outcomes were evaluated and comparisons between patients referred directly through Model-4 Hospital and Model-2/3 Hospitals were analysed.
Patients referred via Model-2/3 had more advanced stage and increased nodal burden compared to Model-4 referrals ((Stage 4 = 53% vs 30%). There were a higher proportion of squamous cell (33%), and small cell carcinomas (13%) in Model-2/3 patients compared to Model 4 (27% &,8%).Out of 249 surgical resections, patients from Model-2/3 (n=152) had larger median tumour size compared to Model-4 (n=97)( (31.72mm vs. 24.74mm, p=0.026) and more advanced nodal stage (N1:14.5%,N2:9.1%vs N1:9.2%, N2:4.2%)(p=0.249).
This study revealed both variation in stage at presentation between regions but also interestingly in patients undergoing surgery for similar stage following PET-CT imaging, post-operative pathology revealed higher tumour and nodal burden. Further research is warranted to determine if this is due to environmental, epigenetic or other factors.