Reported management of lung cancer in Victoria in 1993: comparison with best practice. Anti-Cancer Council of Victoria Lung Cancer Study Group.
OBJECTIVE
To determine recent patterns of management of lung cancer in Victoria in order to stimulate interest in the development of Australian consensus guidelines.


METHODS
A cross-sectional survey of doctors responsible for the care of an incident series of lung cancer patients in 1996-1997.


METHODS
1054 people diagnosed with primary lung cancer in the State of Victoria between 1 January 1993 and 31 July 1993 and notified to the Victorian Cancer Registry.


METHODS
Method of diagnosis; tumour characteristics; factors affecting management plan; first-line and subsequent treatment; outcome; and patients' current status.


RESULTS
Questionnaires were completed for 868 eligible patients (82%): 635 (73%) diagnosed with non-small-cell lung cancer, 124 (14%) diagnosed with small-cell lung cancer, and 109 (13%) with no histological diagnosis. Chest x-ray (814 patients; 94%) and computed tomography (CT) of the chest and abdomen (589 patients; 68%) were the most common investigations, and was the only diagnostic procedure in 48 patients (6%). Treatments were radiotherapy alone or in combination (385 patients; 44%), surgery alone or in combination (196 patients; 23%), chemotherapy alone or in combination (152 patients; 18%); 215 patients (25%) received no antitumour therapy. 243 patients (28%) were treated initially with curative intent. A further 399 (46%) were treated initially with palliative intent, and in 219 (55%) of these good symptom control was achieved. For 427 patients (49%) tumour size was not recorded. While 23% of non-small-cell patients had limited disease, only 8% were investigated with mediastinoscopy. Only four patients (13%) with limited-stage, small-cell lung cancer had combined-modality treatment. There was little use of adjuvant chemotherapy or neoadjuvant therapy. The five-year crude survival rate was 11%.


CONCLUSIONS
The demographics of lung cancer in Victoria are similar to other population-based studies. Patterns of management are not uniform, and are inconsistent with current published guidelines.
Richardson
G E
GE
Department of Medical Oncology & Clinical Haematology, Monash Medical Centre, VIC.
Thursfield
V J
VJ
Giles
G G
GG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015996:Survival Rate; D014739:Victoria / Q000453:epidemiology