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Lung cancer clinical outcomes publication 2019 (for the audit period 2017)

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This is the sixth report on individual activity of surgeons or their specific contribution to lung cancer care. Click below to download the full report and read our executive summary.

Executive summary

This audit report forms the sixth lung cancer clinical outcomes publication (LCCOP). Data from 27 surgical units in England, performing thoracic surgery between 1 January and 31 December 2017, were analysed, following a 6-week period of data validation by surgical units. Key findings include:

  • Overall, 129 surgeons performed lung cancer surgery during the audit period.
  • The number of lung cancer operations performed has risen by 5.4% between 2016 and 2017 to 6,684.
  • Survival at 30 days and at 1 year is high at 98.1% and 88.7% respectively. This was maintained despite the increase in activity this year.
  • There was less variation between trusts than in the previous audit periods, and no negative outlier units were identified.
  • As in previous years we have reported the overall surgical resection rate by trust, but in addition this year we have reported the resection rate in fit patients with early-stage disease. This new measure may be a better measure of surgical quality, as most of these patients should be operable.
  • National resection rates continue to rise, however, there are major differences in unit resection rates, with some units more than twice as likely to operate on cancer patients than others. Addressing this variation could increase the number of patients offered surgery by over 1,000 patients every year.
  • Individual clinician and trust expertise is increasing. The number of operations performed by individual surgeons has risen to a median of 50. Unit activity has risen to a median of 235 cases/year. This compares with 46 cases per surgeon and 203 cases per unit in 2016.
  • Median length of stay following surgery was 6 days. Shorter lengths of stay do not seem to be associated with higher readmission rates.
  • The majority of lung cancer surgery is performed using minimal access approaches, mostly video-assisted thoracic surgery (VATS) (55% compared with 53.4% in 2016).
  • Only 3.5% of resections require pneumonectomy (removal of a whole lung), a historically low level.