title: Longitudinal Follow-up of Lung Cancer Resection From the Society of Thoracic Surgeons General Thoracic Surgery Database in Patients 65 Years and Older.
abstract: BACKGROUND
  The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) does not capture long-term survival after lung cancer surgery. Our objective was to provide longitudinal follow-up to the STS GTSD through linkage to Centers for Medicare and Medicaid Services (CMS) data for patients 65 years of age or older.
  
  
  METHODS
  Lung cancer operations reported in the STS GTSD from 2002 through 2012 were linked to CMS data for patients 65 years of age or older using variables common to both databases with a deterministic matching algorithm. Mortality data were abstracted for each linked patient from the CMS data. The Kaplan-Meier method was used to estimate long-term survival for lung cancer surgery patients based on tumor stage.
  
  
  RESULTS
  From 2002 through 2012, 60,089 lung cancer resections were identified in the GTSD, and 37,009 (61.7%) were in patients 65 years or older. Of these, 26,055 of 37,099 lung cancer resections (70%) in patients 65 years or older were successfully linked to CMS data. Failure to link was most commonly related to having a health maintenance organization or commercial insurance as the primary payer: 40.5% (5,290 of 13,065) of such patients were not linked from 2009 to 2012 (years payer data available). Median survival after lung cancer resection was 6.7 years for pathologic stage I, 3.5 years for stage II, 2.4 years for stage III, and 2.2 years for stage IV.
  
  
  CONCLUSIONS
  The CMS data complement the STS GTSD data by enabling examination of long-term survival and resource utilization in patients 65 years or older. Linked data from the STS GTSD and the CMS will allow for longitudinal analyses of comparative effectiveness among different surgical approaches for the treatment of lung cancer.
authors.affiliation: Emory University, Atlanta, Georgia. Electronic address: felix.fernandez@emoryhealthcare.org.
authors.forename: Felix G
authors.initials: FG
authors.lastname: Fernandez
authors.affiliation: Starr-Wood Cardiac Group, Portland, Oregon.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Furnary
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Andrzej S
authors.initials: AS
authors.lastname: Kosinski
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Onaitis
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Sunghee
authors.initials: S
authors.lastname: Kim
authors.affiliation: Yale University, New Haven, Connecticut.
authors.forename: Daniel
authors.initials: D
authors.lastname: Boffa
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Patricia
authors.initials: P
authors.lastname: Cowper
authors.affiliation: Johns Hopkins All Children's Heart Institute, St. Petersburg, Florida.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Jacobs
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Cameron D
authors.initials: CD
authors.lastname: Wright
authors.affiliation: Baptist MD Anderson Cancer Center, Jacksonville, Florida.
authors.forename: Joe B
authors.initials: JB
authors.lastname: Putnam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology