HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Thomas K. Varghese, Jr Douglas E. Wood Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Farjah, F. Articles by Wood, D. E. Search for Related Content PubMed Articles by Farjah, F. Articles by Wood, D. E. Related Collections Lung - cancer Professional affairs

---

J. Maxwell Chamberlain Memorial Paper for General Thoracic Surgery

Surgeon Specialty and Long-Term Survival After Pulmonary Resection for Lung Cancer

Department of Surgery, University of Washington, Seattle, Washington

Accepted for publication December 1, 2008.

^_* Address correspondence to Dr Wood, University of Washington, Department of Surgery/Division of Cardiothoracic Surgery, Box 356310, 1959 NE Pacific St, Seattle, WA 98195 (Email: dewood{at}u.washington.edu).

Presented at the Forty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Jan 26–28, 2009. Winner of the J. Maxwell Chamberlain Memorial Award for General Thoracic Surgery.

Background: Long-term outcomes and processes of care in patients undergoing pulmonary resection for lung cancer may vary by surgeon type. Associations between surgeon specialty and processes of care and long-term survival have not been described.

Methods: A cohort study (1992 through 2002, follow-up through 2005) was conducted using Surveillance, Epidemiology, and End-Results-Medicare data. The American Board of Thoracic Surgery Diplomates list was used to differentiate board-certified thoracic surgeons from general surgeons (GS). Board-certified thoracic surgeons were designated as cardiothoracic surgeons (CTS) if they performed cardiac procedures and as general thoracic surgeons (GTS) if they did not.

Results: Among 19,745 patients, 32% were cared for by GTS, 45% by CTS, and 24% by GS. Patient age, comorbidity index, and resection type did not vary by surgeon specialty (all p > 0.10). Compared with GS and CTS, GTS more frequently used positron emission tomography (36% versus 26% versus 26%, respectively; p = 0.005) and lymphadenectomy (33% versus 22% versus 11%, respectively; p < 0.001). After adjustment for patient, disease, and management characteristics, hospital teaching status, and surgeon and hospital volume, patients treated by GTS had an 11% lower hazard of death compared with those who underwent resection by GS (hazard ratio, 0.89; 99% confidence interval, 0.82 to 0.97). The risks of death did not vary significantly between CTS and GS (hazard ratio, 0.94; 99% confidence interval, 0.88 to 1.01) or GTS and CTS (hazard ratio, 0.94; 99% confidence interval, 0.87 to 1.03).

Conclusions: Lung cancer patients treated by GTS had higher long-term survival rates than those treated by GS. General thoracic surgeons performed preoperative and intraoperative staging more often than GS or CTS.

This article has been cited by other articles:

				D. E. Wood and F. Farjah Surgeon specialty is associated with better outcomes: the facts speak for themselves. Ann. Thorac. Surg., November 1, 2009; 88(5): 1393 - 1395. [Full Text] [PDF]