title: Survival after resection for lung cancer is the outcome that matters.
abstract: BACKGROUND
  Lung cancer is the leading cause of cancer mortality in the United States. Stage-specific survival is well documented in national data sets; however, there remains limited recording of longitudinal survival in individual centers.
  
  
  METHODS
  The VistA Surgery Package was employed to list operations performed by the thoracic surgery service at one Veterans Administration (VA) Medical Center.
  
  
  RESULTS
  During a period of 107 months, 416 thoracic operations were performed, 211 of them for lung cancer. Stage distribution was 66% stage I, 18% stage II, 12% stage III, and 4% stage IV. During follow-up, 102 patients died, 57 of them from disease-specific causes. Median survival was 39 months for stage I. Disease-specific median survival was 83 months for stage I, and 5-year survival was 52% (72% for stage IA and 32% for stage IB).
  
  
  CONCLUSIONS
  Pulmonary resection offers high disease-free survival for early-stage lung cancer. Decentralized hospital computer programming (DHCP) allows individual oncology programs to reliably measure survival. Use of this important outcome measure in quality improvement programs facilitates realistic counseling of patients and meaningful assessments of practice effectiveness.
authors.affiliation: Department of Surgery, Cincinnati Veterans Administration Medical Center, Cincinnati, OH, USA. Michael.reed@uc.edu
authors.forename: Michael F
authors.initials: MF
authors.lastname: Reed
authors.forename: Mark
authors.initials: M
authors.lastname: Molloy
authors.forename: Erica L
authors.initials: EL
authors.lastname: Dalton
authors.forename: John A
authors.initials: JA
authors.lastname: Howington
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods / Q000401:mortality; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D016896:Treatment Outcome