Factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data
Background Thirty-day mortality after treatment for lung cancer is a measure of unsuccessful outcome and where treatment should have been avoided. Guidelines recommend offering chemotherapy to individuals with small cell lung cancer (SCLC) who have poorer performance status (PS) because of its high...
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| Format: | Article |
| Language: | English English English |
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Elsevier
2018
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| Online Access: | https://eprints.nottingham.ac.uk/54974/ |
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| author | Jones, Gavin S. McKeever, Tricia M. Hubbard, Richard B. Khakwani, Aamir Baldwin, David R. |
| author_facet | Jones, Gavin S. McKeever, Tricia M. Hubbard, Richard B. Khakwani, Aamir Baldwin, David R. |
| author_sort | Jones, Gavin S. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background
Thirty-day mortality after treatment for lung cancer is a measure of unsuccessful outcome and where treatment should have been avoided. Guidelines recommend offering chemotherapy to individuals with small cell lung cancer (SCLC) who have poorer performance status (PS) because of its high initial response rate. However, this comes with an increased risk of toxicity and early death. We quantified real-world 30-day mortality in SCLC following chemotherapy, established the factors associated with this and compared these to the factors that influence receipt of chemotherapy.
Methods
We used linked national English datasets to define the factors associated with both receiving chemotherapy and 30-day mortality following chemotherapy.
Results
We identified 3,715 people diagnosed with SCLC, of which 2,235 (60.2%) received chemotherapy. There were 174 (7.8%) deaths within 30 days of chemotherapy. The adjusted odds of receiving chemotherapy decreased with older age, worsening PS and increasing comorbidities. Thirty-day mortality was independently associated with poor PS (PS 2 vs PS 0 adjusted OR 3.75 95% CI 1.71-8.25) and stage (extensive vs limited adjusted OR 1.68 95% CI 1.03-2.74) but in contrast was not associated with increasing age. Both chemotherapy administration and 30-day mortality varied by hospital network.
Conclusions
To reduce variation in chemotherapy administration predictors of 30-day mortality could be used as an adjunct to improve sub-optimal patient selection. We have quantified 30-day mortality risk by the two independently associated factors, PS and stage, so that patients and clinicians can make better informed decisions about the potential risk of early death following chemotherapy. |
| first_indexed | 2025-11-14T20:30:10Z |
| format | Article |
| id | nottingham-54974 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English English English |
| last_indexed | 2025-11-14T20:30:10Z |
| publishDate | 2018 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-549742019-08-20T04:30:15Z https://eprints.nottingham.ac.uk/54974/ Factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data Jones, Gavin S. McKeever, Tricia M. Hubbard, Richard B. Khakwani, Aamir Baldwin, David R. Background Thirty-day mortality after treatment for lung cancer is a measure of unsuccessful outcome and where treatment should have been avoided. Guidelines recommend offering chemotherapy to individuals with small cell lung cancer (SCLC) who have poorer performance status (PS) because of its high initial response rate. However, this comes with an increased risk of toxicity and early death. We quantified real-world 30-day mortality in SCLC following chemotherapy, established the factors associated with this and compared these to the factors that influence receipt of chemotherapy. Methods We used linked national English datasets to define the factors associated with both receiving chemotherapy and 30-day mortality following chemotherapy. Results We identified 3,715 people diagnosed with SCLC, of which 2,235 (60.2%) received chemotherapy. There were 174 (7.8%) deaths within 30 days of chemotherapy. The adjusted odds of receiving chemotherapy decreased with older age, worsening PS and increasing comorbidities. Thirty-day mortality was independently associated with poor PS (PS 2 vs PS 0 adjusted OR 3.75 95% CI 1.71-8.25) and stage (extensive vs limited adjusted OR 1.68 95% CI 1.03-2.74) but in contrast was not associated with increasing age. Both chemotherapy administration and 30-day mortality varied by hospital network. Conclusions To reduce variation in chemotherapy administration predictors of 30-day mortality could be used as an adjunct to improve sub-optimal patient selection. We have quantified 30-day mortality risk by the two independently associated factors, PS and stage, so that patients and clinicians can make better informed decisions about the potential risk of early death following chemotherapy. Elsevier 2018-07-24 Article PeerReviewed application/pdf en cc_by_nc_nd https://eprints.nottingham.ac.uk/54974/1/Final%20EJC.pdf image/jpeg en cc_by_nc_nd https://eprints.nottingham.ac.uk/54974/2/file.jx1.jpg image/jpeg en cc_by_nc_nd https://eprints.nottingham.ac.uk/54974/3/file.jx.jpg Jones, Gavin S., McKeever, Tricia M., Hubbard, Richard B., Khakwani, Aamir and Baldwin, David R. (2018) Factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data. European Journal of Cancer . ISSN 0959-8049 (In Press) Small cell lung cancer; Chemotherapy; Epidemiology; 30-day mortality |
| spellingShingle | Small cell lung cancer; Chemotherapy; Epidemiology; 30-day mortality Jones, Gavin S. McKeever, Tricia M. Hubbard, Richard B. Khakwani, Aamir Baldwin, David R. Factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data |
| title | Factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data |
| title_full | Factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data |
| title_fullStr | Factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data |
| title_full_unstemmed | Factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data |
| title_short | Factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data |
| title_sort | factors influencing treatment selection and thirty-day mortality following chemotherapy for people with small cell lung cancer: an analysis of national audit data |
| topic | Small cell lung cancer; Chemotherapy; Epidemiology; 30-day mortality |
| url | https://eprints.nottingham.ac.uk/54974/ |