Burghuber Otto C, Kirchbacher Klaus, Mohn-Staudner Andrea, Hochmair Maximilian, Breyer Marie-Kathrin, Studnicka Michael, Mueller Michael Rolf, Feurstein Petra, Schrott Andrea, Lamprecht Bernd, Eckmayr Josef, Renner Friedrich, Bolitschek Josef, Pohl Wolfgang, Schenk Peter, Errhalt Peter, Cerkl Peter, Baumgartner Bernhard, Kneussl Meinhard, Hartl Sylvia
First Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria.
Medical School, Sigmund Freud University, Vienna, Austria.
Clin Med Insights Oncol. 2020 Sep 10;14:1179554920950548. doi: 10.1177/1179554920950548. eCollection 2020.
The Austrian Lung Cancer Audit (ALCA) is a pilot study to evaluate clinical and organizational factors related to lung cancer care across Austria.
The ALCA is a prospective, observational, noninterventional cohort study conducted in 17 departments in Austria between September 2013 and March 2015. Participating departments were selected based on an annual case load of >50 patients with lung cancer.
The ALCA included 745 patients, representing 50.5% of all newly diagnosed cancer cases during that time period. In 75.8% of patients, diagnosis was based on histology, and in 24.2% on cytology; 83.1% had non-small-cell lung cancer, 16.9% small-cell lung cancer; and only 4.6% had to be classified as not otherwise specified cancers. The median time elapsed between first presentation at hospital and diagnosis was 8 days (interquartile range [IQR]: 4-15; range: 0-132); between diagnosis and start of treatment it was 15 days for chemotherapy (IQR: 9-27; range: 0-83), 21 days (IQR: 10-35; range: 0-69) for radiotherapy, and 24 days (IQR: 11-36; range: 0-138) for surgery, respectively. In 150 patients undergoing surgical treatment, only 3 (2.0%; n = 147, 3 missings) were seen with postoperative restaging indicating unjustified surgery. One-year follow-up data were available for 723 patients, indicating excellent 49.8% survival; however, a wide range of survival between departments (range: 37.8-66.7) was seen.
The ALCA conducted in high case load departments indicated management of lung cancer in accordance with international guidelines, and overall excellent 1-year survival.
奥地利肺癌审计(ALCA)是一项试点研究,旨在评估奥地利全国范围内与肺癌护理相关的临床和组织因素。
ALCA是一项前瞻性、观察性、非干预性队列研究,于2013年9月至2015年3月在奥地利的17个科室开展。参与研究的科室是根据每年肺癌患者病例数超过50例来选择的。
ALCA纳入了745例患者,占该时间段内所有新诊断癌症病例的50.5%。75.8%的患者诊断基于组织学,24.2%基于细胞学;83.1%为非小细胞肺癌,16.9%为小细胞肺癌;只有4.6%的病例不得不归类为未另行特指的癌症。从首次到医院就诊至确诊的中位时间为8天(四分位间距[IQR]:4 - 15天;范围:0 - 132天);从确诊到开始化疗的时间为15天(IQR:9 - 27天;范围:0 - 83天),放疗为21天(IQR:10 - 35天;范围:0 - 69天),手术为24天(IQR:11 - 36天;范围:0 - 138天)。在150例接受手术治疗的患者中,只有3例(2.0%;n = 147,3例缺失数据)术后再分期显示手术不合理。723例患者有1年随访数据,显示生存率高达49.8%;然而,各科室之间的生存率差异较大(范围:37.8% - 66.7%)。
在高病例数科室开展的ALCA表明,肺癌管理符合国际指南,且总体1年生存率良好。