Study of More Than 4,000 Patients Reveals Better Survival Compared to Standard Care
Lung cancer remains the leading cause of cancer death worldwide with a five-year survival rate of 17%. The need for ways to improve survival is clear.
A new Stony Brook study of short- and long-term survival outcomes of more than 4,000 lung cancer patients reveals that patients treated under a multidisciplinary model of care have significantly higher survival rates at one, three, five, and 10 years post diagnosis compared to patients treated with a standard or traditional model of care.
The study — titled "Survival Outcomes Among Lung Cancer Patients Treated Using a Multidisciplinary Team Approach" and published online in Clinical Lung Cancer (see report) — was conducted by Thomas V. Bilfinger, MD, ScD, professor of surgery and director of the Lung Cancer Evaluation Center (LCEC), and his colleagues at Stony Brook Medicine.
This study represents the first large-scale published investigation in the United States documenting the significant survival benefit of a multidisciplinary care approach to the diagnosis and treatment of patients with lung cancer.
Stony Brook's Lung Cancer Evaluation Center was established in 2000 to implement
the multidisciplinary care approach to evaluate, treat, and monitor patients with lung cancer.
Hospitals nationwide typically use a standard model of care when treating lung cancer patients. While this model offers multiple services to patients such as surgical, radiation oncology, oncology, and imaging services, the responsibility of care generally falls on the patient, and communication and coordination between all groups are often segmented.
The LCEC multidisciplinary model of care coordinates all aspect of patient care through a core group that meets regularly to plan each patient's care on an individual basis.
The core group involves specialists from multiple departments involved in patient care, such as medical oncology, surgery, radiation oncology, pathology, imaging, pulmonology, and nutrition. Patients' primary care physicians are also involved in the coordinated care, and cancer database experts are involved to investigate outcomes measures on a case-by-case patient basis.
"There is near universal interest in deploying multidisciplinary structures of care to improve outcomes in lung cancer, but to date implementation of such models has been slow because of the lack of supporting data," says Dr. Bilfinger.
"Our findings show data that outcomes are improved with a multidisciplinary care and communications model, and should be considered as a 'best practice' guideline for treating all lung cancer patients."
The findings from the Stony Brook study add to a limited but increasing evidence base
supporting the use of the multidisciplinary approach in cancer care and its survival benefits.
The researchers used the Stony Brook Cancer Center registry to identify patients diagnosed and treated from 2002 to 2016. They compared 1,956 patients participating in the multidisciplinary care model and 2,315 patients receiving traditional care.
After adjusting for biases and matching data, they found that, overall, patients participating in the multidisciplinary process had a one-third survival advantage out to 10 years.
The five-year survival rates for those receiving the multidisciplinary model form of care was 33.6%, compared to 23.0% for those receiving the traditional care approach — a finding that illustrates patients are living longer with the multidisciplinary model of care.
Dr. Bilfinger and colleagues also point out that this model may be particularly effective when diagnosing lung cancer at an earlier stage.
For patients diagnosed in stage 1 of disease, the one-year survival rate is 92.4% with the multidisciplinary model versus 79.2% with standard care. The five-year survival rates for stage 1 diagnosed patients are 52.5% and 32.8%, respectively.
Co-authors of the study are Barbara Nemesure, PhD, of the Department of Family, Population and Preventive Medicine; Roger Keresztes, MD, of the Department of Medicine; Denise Albano, DNP, of the Department of Surgery, and Muhammed Perwaiz, MD, of the Department of Medicine.
The LCEC continues to build its multidisciplinary team model for treating and monitoring lung cancer patients, and expects to expand this practice at other Stony Brook-affiliated hospitals and clinics.
| "We sought to determine whether a multidisciplinary team (MDT) approach to lung cancer care yields superior outcomes to a traditional care model. The present investigation included more than 4,000 patients and compared the survival outcomes between lung cancer patients participating in an MDT program and those receiving traditional care. The results suggest a significant survival benefit with the MDT approach for the diagnosis and treatment of lung cancer." — Bilfinger et al. |
