Actual status of adjuvant chemotherapy for non-small-cell lung cancer at one Japanese cancer center: the need for increased cooperation between medical oncologists and surgeons.
Adjuvant chemotherapy improves the prognosis of patients with non-small-cell lung cancer (NSCLC) treated by complete resection. At Shizuoka Cancer Center, thoracic surgeons evaluate the indications for adjuvant chemotherapy, and once a patient is judged as suitable for adjuvant chemotherapy, uracil-tegafur (UFT) is prescribed by them mainly in cases of stage IB, or the patient is referred to a medical oncologist for parenteral chemotherapy mainly in cases of stages IIA to IIIA. However, both the medical oncologists and the surgeons at our institute often encounter differences in attitudes toward adjuvant chemotherapy among them. One hundred and nine patients with NSCLC, of pathological stages IB to IIIA, who underwent complete resection at our institute, between April 2005 and June 2007, were recruited for this study. By reviewing medical charts of the patients and interviewing medical oncologists and surgeons at our institute, we mainly analyzed the differences in the judgment of the patients' suitability for adjuvant chemotherapy among surgeons and the differences in the proportion of patients who agreed to the adjuvant chemotherapy recommended by the medical oncologists. The proportion of patients judged as unsuitable for adjuvant chemotherapy by one surgeon was higher when compared with that by the other three surgeons. While all patients who were referred to two medical oncologists agreed to the adjuvant chemotherapy, few patients referred to the other medical oncologists agreed. This study revealed that there were considerable differences in whether patients consented to adjuvant chemotherapy depending on the medical oncologists that they were referred to, and suggested possible differences in the judgment of the patients' suitability for adjuvant chemotherapy among surgeons.
Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-gun, Shizuoka, 411-8777, Japan. tshukuya@juntendo.ac.jp
Takehito
T
Shukuya
Toshiaki
T
Takahashi
Akihiro
A
Tamiya
Akira
A
Ono
Satoshi
S
Igawa
Yukiko
Y
Nakamura
Asuka
A
Tsuya
Haruyasu
H
Murakami
Masahiro
M
Endo
Yasuhisa
Y
Ohde
Kazuo
K
Nakagawa
Takehiro
T
Okumura
Haruhiko
H
Kondo
Nobuyuki
N
Yamamoto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007258:Informed Consent; D033183:Interdisciplinary Communication; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010348:Patient Care Team; D018579:Patient Selection; D011013:Pneumonectomy; D012189:Retrospective Studies; D005641:Tegafur / Q000627:therapeutic use*; D013903:Thoracic Surgery
D000964:Antimetabolites, Antineoplastic; D005641:Tegafur