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 | 2008 |
| Volume (lobectomy cases) | |||||
| VATS lobectomy procedures (%) | 174 (91%) | 194 (93%) | 191 (89%) | 166 (95%) | 157 (90%) |
| Open lobectomy procedures (%) | 18 (9%) | 15 (7%) | 23 (11%) | 9 (5%) | 17 (10%) |
| Average length of stay | |||||
| VATS lobectomy procedures | 4 | 4 | 3 | 3 | 5 |
| Open lobectomy procedures | 6 | 7 | 9 | 6 | 8 |
| Peri-op Mortality Rate | |||||
| VATS lobectomy procedures | 1% | 0% | 1% | 1.8%* | 0.62%* |
| Open lobectomy procedures | 6% | 7% | 0% | 0% | 0% |
| Complication Rate | |||||
| VATS lobectomy procedures | 5% | 7% | 7% | 12% | 9.8% |
| Open lobectomy procedures | 6% | 13% | 22% | 22% | 15.38% |
Survival Rates for Patients with Non-Small Cell Lung Cancer
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.
These graphs show the percentage of patients with stage 0, I, II, III or IV cancer who survived at one, two, three, four and five years from diagnosis. The patients represented in the graphs were diagnosed between 1998 to 2001.
Patients have up to five years of follow-up and have been assessed as of 2006 (the most recent year for which data have been compiled).
Stage 1 Lung Cancer Survival Rates
The chart at left shows the percentage of patients surviving with Stage 1 lung cancer for one to five years after diagnosis.
The gray shaded area represents the range of survival for patients at Cedars Sinai Medical Center (as reported to the California Cancer Registry).
The solid line represents survival for the entire United States, as reported to the National Cancer Database.
The dotted line represents the survival in California, also as reported to the National Cancer Database.
Stage 2 Lung Cancer Survival Rates
The chart at right shows the percentage of patients with Stage 2 lung cancer who survived for one to five years.
Again, the shaded gray area shows the range of survival for patients at Cedars Sinai Medical Center (as reported to the California Cancer Registry).
The solid line represents survival rates for the entire United States, as reported to the National Cancer Database.
The dotted line represents the survival in California, also as reported to the National Cancer Database.
Stage 3 Lung Cancer Survival Rates
At left, the chart shows the percentage of patients with Stage 3 lung cancer who survived one to five years from their diagnosis.
The gray shaded area represents the range of survival for patients at Cedars Sinai Medical Center (as reported to the California Cancer Registry).
The solid line represents survival for the entire United States, as reported to the National Cancer Database.
Stage 4 Lung Cancer Survival Rates
The chart at right shows the percentage of patients with Stage 4 lung cancer who survived one through five years.
The shaded gray area shows the range of survival for patients at Cedars Sinai Medical Center (as reported to the California Cancer Registry).
The solid line represents survival for the entire United States, as reported to the National Cancer Database.
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, 2006 and 2007.
