Longitudinal Follow-up of Lung Cancer Resection From the Society of Thoracic Surgeons General Thoracic Surgery Database in Patients 65 Years and Older

摘要

Institutional Review Board ApprovalThe Society of Thoracic Surgeons General Thoracic Surgery DatabaseMedicare Database of Centers for Medicare and Medicaid ServicesLinkage of The Society of Thoracic Surgeons Records to Centers for Medicare and Medicaid Services DataLung Cancer StagingStatistical AnalysisDiscussionSupplementary DataReferencesThe 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.MethodsLung 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.ResultsFrom 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.ConclusionsThe 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.The AppendixAppendix can be viewed in the online version of this article [http://dx.doi.org/10.1016/j.athoracsur.2016.03.034] on http://www.annalsthoracicsurgery.org.General Thoracic Surgery:The Annals of Thoracic Surgery CME Program is located online at http://www.annalsthoracicsurgery.org/cme/home. To take the CME activity related to this article, you must have either an STS member or an individual non-member subscription to the journal.The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) was established in 2002 as a component of the STS National Database to support quality improvement efforts in general thoracic surgery [