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National data analysis clarifies best approaches to lung cancer treatment

A Washington University thoracic surgeon at Barnes-Jewish Hospital is examining national data sets to determine which lung cancer treatments lead to the best patient outcomes at various stages of the disease. These studies may help shape lung cancer treatment nationwide

November 20, 2014

Surgeon Varun Puri, MD, with the help of second-year medical student Aalok Patel, has reviewed data from the National Cancer Database to determine patterns of care for patients with locally advanced stage III lung cancer and to identify which treatments offered the best outcomes.

The role of surgery in these patients has been controversial. But the study, published in the Journal of Thoracic Oncology, found that patients who undergo an operation, or resection, have significantly improved long-term survival compared to patients who undergo just chemoradiation therapy.

“We are now considering surgical resection for patients with stage III lung cancer more openly than we were before,” says Puri.

Cancer database access

Puri was given access to the National Cancer Database—which combines data from the American College of Surgeons and the American Cancer Society—after submitting a competitive application that outlined his intended study of the data.

“Aalok and I have worked on almost 10 projects from this database,” says Puri. And their work continues. In their latest studies, he and Patel are looking at:

  • cost-effectiveness of alternative forms of treatment for locally advanced lung cancer
  • predictors that may better inform surgical outcomes
  • treatment and outcomes in various subtypes of lung cancer
  • demographic and socioeconomic reasons patients are undertreated for lung cancer

Washington University thoracic surgeon Traves Crabtree, MD, was also awarded access to the National Cancer Database to study treatment and outcomes in esophageal cancer. Surgical resident Pamela Samson, MD, will help analyze the data.

Puri and Crabtree collaborate closely with thoracic surgery chief Bryan Meyers, MD, MPH, radiation oncologists Jeffrey Bradley, MD, Clifford Robinson, MD, and others in the care of lung cancer patients. They have also published several studies comparing surgery and radiation therapy in high-risk, stage I lung cancer patients at the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.

Read more about deciding between lung cancer surgery and radiation therapy in Outlook magazine.