dc.contributor.author |
Stevens, W |
en |
dc.contributor.author |
Stevens, G |
en |
dc.contributor.author |
Kolbe, John |
en |
dc.contributor.author |
Cox, B |
en |
dc.date.accessioned |
2012-05-01T03:52:19Z |
en |
dc.date.issued |
2008-10-01 |
en |
dc.identifier.citation |
Internal Medicine Journal 38(10):758-768 01 Oct 2008 |
en |
dc.identifier.issn |
1444-0903 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/17672 |
en |
dc.description.abstract |
Background: Lung cancer survival statistics for New Zealand (NZ) are poor relative to Australia, USA, Canada and some European countries for reasons that are unknown. As patients with early-stage non-small-cell lung cancer (NSCLC) have the highest chance of survival, appropriate management disproportionately influences survival rates. The aim of this study was to assess management of stage I/II NSCLC, whether management differed from international practice, and factors influencing curative management. Methods: Management of patients with stages I and II NSCLC was determined from an audit of secondary care in Auckland and Northland for patients with lung cancer diagnosed in 2004 (565). Results: Of the 142 cases with stage I or II NSCLC, 79 patients (56%) were treated with curative intent and 61 (44%) were managed palliatively. Of those treated curatively, 69 underwent surgical resection, 9 received definitive radiation therapy and a single patient received concurrent chemo-irradiation. Of those managed palliatively, 21 received anticancer treatment and 40 received supportive care. Increasing age and comorbidity reduced the chances of receiving curative treatment (P < 0.001, P = 0.004, respectively); however, discussion at a multidisciplinary meeting was associated with increased likelihood of curative management (P < 0.001). Disparity between NZ and overseas practice increased with increasing age and comorbidity. Only half of those managed curatively commenced treatment within internationally recommended time frames. Conclusion: Relatively fewer patients received potentially curative treatment in this NZ study than in countries with better survival outcomes and many were not managed within recommended time frames. Management differences increased with increasing age and comorbidity, possibly suggesting more nihilistic attitudes in NZ. |
en |
dc.language |
English |
en |
dc.publisher |
WILEY-BLACKWELL |
en |
dc.relation.ispartofseries |
Internal Medicine Journal |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.subject |
Science & Technology |
en |
dc.subject |
Life Sciences & Biomedicine |
en |
dc.subject |
Medicine, General & Internal |
en |
dc.subject |
General & Internal Medicine |
en |
dc.subject |
lung cancer |
en |
dc.subject |
carcinoma non-small-cell lung |
en |
dc.subject |
management |
en |
dc.subject |
surgery |
en |
dc.subject |
New Zealand |
en |
dc.subject |
RANDOMIZED CONTROLLED-TRIALS |
en |
dc.subject |
ELDERLY-PATIENTS |
en |
dc.subject |
SURVIVAL |
en |
dc.subject |
SURGERY |
en |
dc.subject |
CARE |
en |
dc.subject |
RADIOTHERAPY |
en |
dc.subject |
PATTERNS |
en |
dc.subject |
METAANALYSIS |
en |
dc.subject |
COMORBIDITY |
en |
dc.subject |
AUSTRALIA |
en |
dc.title |
Management of stages I and II non-small-cell lung cancer in a New Zealand study: divergence from international practice and recommendations |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1111/j.1445-5994.2007.01523.x |
en |
pubs.issue |
10 |
en |
pubs.begin-page |
758 |
en |
pubs.volume |
38 |
en |
dc.identifier.pmid |
18298555 |
en |
pubs.author-url |
http://onlinelibrary.wiley.com/doi/10.1111/j.1445-5994.2007.01523.x/abstract |
en |
pubs.end-page |
768 |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
184332 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Medicine Department |
en |
pubs.record-created-at-source-date |
2013-06-05 |
en |
pubs.dimensions-id |
18298555 |
en |