Measuring the Quality of Lung Cancer Treatment at Cedars-Sinai
Thoracic surgeons at the Women's Guild Lung Institute continually monitor the quality of care provided to patients with lung cancer who come to the center for treatment. Among the aspects of care that are measured are:
- Volume of surgery. Research indicates that those medical centers that do the most number of thoracic surgeries tend to have the best outcomes for patients. At Cedars-Sinai, surgeons look at a compare volumes and outcomes for patients receiving minimally invasive video-assisted thoraoscopic surgery (VATS) and more traditional open surgery. VATS surgery has been shown results comparable to open surgery but with less pain, fewer deaths following surgery and shorter stays in the hospital.
- Average length of stay in the hospital. Patients tend to get better faster when they recover in a familiar setting. Spending less time in a hospital also means less exposure to infections and other diseases.
- Mortality rate following surgery. This is the number of patients who die following surgery.
- Complication rates. Major surgery can sometimes lead to complications. For a person undergoing surgery for lung cancer, complications can include pneumothorax (air leaking from the lungs for seven days or more), irregular heart beats (atrial fibrillation) that requires treatment and respiratory or heart failure.
| Lung Cancer Patients | 2004 | 2005 | 2006 | 2007 |
| Volume (lobectomy cases) | ||||
| VATS lobectomy procedures (%) | 174 (91%) | 194 (93%) | 191 (89%) | 166 (95%) |
| Open lobectomy procedures (%) | 18 (9%) | 15 (7%) | 23 (11%) | 9 (5%) |
| Average length of stay | ||||
| VATS lobectomy procedures | 4 | 4 | 3 | 3 |
| Open lobectomy procedures | 6 | 7 | 9 | 6 |
| Peri-op Mortality Rate | ||||
| VATS lobectomy procedures | 1% | 0% | 1% | 1.8%* |
| Open lobectomy procedures | 6% | 7% | 0% | 0% |
| Complication Rate | ||||
| VATS lobectomy procedures | 5% | 7% | 7% | 12% |
| Open lobectomy procedures | 6% | 13% | 22% | 22% |
Survival Rates for Patients with Non-Small Cell Lung Cancer Following VATS Lobectomy
About three out of every four cases of lung cancer is non-small cell lung cancer. This type of cancer can be treated with surgery, if it has not spread to other major organs of the body.
There are four stages of non-small cell lung cancer. This staging system is important for determining the prognosis and treatment for lung cancer:
- Stage I is a cancer confined to the lung.
- Stage II is a cancer that has spread to lymph nodes near the tumor and within the lung.
- Stage III cancer is confined to the chest, but it has spread more widely through the tissues in the chest.
- Stage IV cancer has spread to other parts of the body, such as the brain, liver or bones.
The earlier lung cancer is diagnosed and the less it has spread, the better a person's chances for survival. The table below shows survival rates for patients treated at Cedars-Sinai based on the stage of their cancer.
| Survival Rates for Non Small Cell Lung Cancer Post-VATS Lobectomy | |||||||
| Years | Cumulative Percentage of Patients Surviving by Stage | ||||||
| 1A | 1B | 2A | 2B | 3A | 3B | ||
| 1 | 93% | 92% | 86% | 93% | 82% | 100% | |
| 2 | 88% | 83% | 73% | 89% | 52% | 87% | |
| 3 | 83% | 80% | 67% | 75% | 43% | 87% | |
| 4 | 83% | 78% | 56% | 75% | 38% | 87% | |
| 5 | 80% | 68% | 56% | 75% | 38% | ||
| 6 | 80% | 68% | 56% | 75% | |||
| 7 | 76% | ||||||
| 8 | 76% | ||||||
| 9 | 38% | ||||||
| 10 | 38% | ||||||
| Number of patients treated | 497 | 245 | 49 | 59 | 108 | 17 | |
Comparisons of Cedars-Sinai Medical Center with Other Hospitals
Cedars-Sinai continually focuses on improving the quality of its care. The California Office of Statewide Health Planning and Development (OSHPD) collects data on the volumes of lung cancer patients treated at California hospitals. Cedars-Sinai Medical Center has ranked as having the highest volume of lung cancer patients of any California hospital in 2004, 2005 and 2006.
