title: Status and Perspectives of Clinical Modes in Surgical Patients With Lung Cancer: A Retrospective Study.
abstract: To investigate the association between the clinical characteristics and clinical modes of surgically treated lung cancer patients, we conducted a retrospective study with 1097 lung cancer patients receiving pulmonary resection between 2012 and 2013.A physical examination or screening (PES) group (n = 267) and a symptomatic (SY) group (n = 830) were established depending on the new clinical mode (sequence of physical examination, early detection and sequential medical treatment) and the conventional mode (hospitalization due to occurrence of relevant symptoms), respectively.A higher proportion of patients referred to our unit directly form a junior medical unit is found in PES group (43.8%, 117/267 vs 13.6%, 113/830) (P < 0.001) and 37.5% (100/267) patients in PES group spent <1 months from detection or first medical visit to diagnosis compared with 15.4% (128/830) patient in SY group (P < 0.001). A significantly higher proportion of PES patients versus SY patients received video-assisted thoracoscopic surgery (VATS) resection (67.8%, 183/267 vs 42.6%, 352/830; P < 0.001). A significantly higher proportion of PES patients versus SY patients chose sublobar resection (16.9%, 45/267 vs 7.6%, 63/830; P < 0.001). A significantly higher proportion of PES patients versus SY patients are at stage 0 or I (64.4%, 172/267 vs 40.7%, 338/830; P < 0.000). The postoperative incidence rate of complications in 30 days is significantly higher in SY group than in PES group (34.9% vs 27.3%; P = 0.022).Helping to early diagnosis and surgical treatment, early tumor detection via PES may contribute to significantly higher proportions of early-stage lung cancer, use of VATS pulmonary resection, and sublobectomy as well as lower complication rate.
authors.affiliation: From the Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China (YL, HD, XW, CS, JH, GC); and Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, P.R. China (WL).
authors.forename: Yutian
authors.initials: Y
authors.lastname: Lai
authors.forename: Heng
authors.initials: H
authors.lastname: Du
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Cheng
authors.initials: C
authors.lastname: Shen
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.forename: Weiming
authors.initials: W
authors.lastname: Li
authors.forename: Guowei
authors.initials: G
authors.lastname: Che
mesh_terms: D000367:Age Factors; D000368:Aged; D001707:Biopsy, Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010808:Physical Examination / Q000379:methods; D011013:Pneumonectomy / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods / Q000401:mortality*; D013997:Time Factors; D016896:Treatment Outcome