You are using an outdated browser. We suggest you update your browser for a better experience. Click here for update.
Close this notification.
Skip to main content Skip to search

Lung Resection for Stage 1 Patients Methodology

Surgery for Stage 1 Lung Cancer Patients
Short description of Indicator Proportion of patients diagnosed with stage 1 lung cancer that had a surgery within 180 days of diagnosis.
Rationale for measurement Surgical resection is the treatment of choice for early stage lung cancer.[1] Patients with stage 1 disease have the most favourable prognosis.[1] A population-based study concluded that survival was favourable for resected early stage lung cancer patients, including groups such as elderly patients and those with multiple tumours.[2] Five-year survival rates after resection range between 55% and 80%.[1]
Evidence/references for rationale
  1. Hung, J. J., Hsu, W. H., Hsieh, C. C., Huang, B. S., Huang, M. H., Liu, J. S., & Wu, Y. C. (2009). Post-recurrence survival in completely resected stage 1 non-small cell lung cancer with local recurrence. Thorax, 64(3), 192-196.
  2. Strand, T. E., Rostad, H., Møller, B., & Norstein, J. (2006). Survival after resection for primary lung cancer: a population based study of 3211 resected patients. Thorax, 61(8), 710-715.​
Calculations for the indicator

Percentage of patients diagnosed with stage 1 lung cancer that had a surgery within 180 days of diagnosis = (Number of stage 1 lung cancer patients that had a surgery within 180 days)/(Number of patients diagnosed with stage 1 lung cancer between 2013 and 2017)

Percentage of patients diagnosed with stage 1 lung cancer in 2017 that had a surgery within 180 days of diagnosis by age = (Number of stage 1 lung cancer patients that had a surgery within 180 days)/(Number of patients diagnosed with stage 1 lung cancer in 2017)

Standardized Rate Calculation N/A
Unit Percentage (%)
Data sources Ontario Cancer Registry (OCR), CIHI Discharge Abstracts Database (DAD), CIHI National Ambulatory Care Database (NACRS); Lung quality-based procedure (QBP) diagnosis and procedure code lists​
Time Frame CY 2013-2017​
Geographic Scale Provincial
Denominator description

All incident lung cancer cases from OCR with diagnosis date from January 1, 2013 to December 31, 2017, and stage 1A or 1B at diagnosis.

Classify patients into the following age groups by age at diagnosis: under 50, 50 to 64, 65 to 79, 80 and older

Exclusions:

  1. Non-solid tumours (lymphomas, myeloma etc.), mesothelioma, sarcoma (Histology codes: 9050-9055, 9140, 9590-9992)
  2. Cases where method of cancer diagnosis confirmation is unknown, or the sole source of confirmation is death certificate)
  3. Cases with undefined stage of diagnosis
  4. Patients younger than 18 at the date of diagnosis
  5. Patients with invalid/generic HCN in OCR
  6. Ontario residents at the time of diagnosis
  7. Patients who died within 180 days of diagnosis without receiving a surgery
Numerator description

Select all records from DAD/NACRS with most resource-intensive intervention being a QBP lung resection and main diagnosis (MRDx) of cancer or suspected cancer with resection date (DAD)/registration date (NACRS) within 180 days of diagnosis.

If a patient had multiple surgeries, select the one closest to the date of diagnosis.

Classify lung incidents by the time between resection and surgery into:

  • no surgery (cases that did not have a surgery within 180 days of diagnosis)
  • surgery within 180 days of diagnosis

Exclusions:

  1. Surgeries in the thoracic area other than lung
  2. Surgical resections where main intervention was not a lung resection
  3. Surgeries where main diagnosis was other than lung (as defined by ICD-10 code)
Considerations 
  • If a patient has multiple lung diagnoses - select the first one.
  • Only main intervention and main diagnosis are considered in surgery definition.
Data availability & limitations
  • Date of death is taken from OCR. Dates up to June 2018 are used and are considered complete.