SCI

29 March 2023

Institution-Level Evolution of Lung Cancer Resection Quality with Implementation of a Lymph Node Specimen Collection Kit

(JTO, IF: 20.121)

Akinbobola Olawale,Ray Meredith A,Fehnel Carrie et al. Institution-Level Evolution of Lung Cancer Resection Quality with Implementation of a Lymph Node Specimen Collection Kit.[J] .J Thorac Oncol, 2023, undefined: undefined.

BACKGROUND 背景

Lung cancer surgery with a lymph node kit improves patient-level outcomes, but institution-level impact is unproven.

肺癌手术与淋巴结采集盒改善患者层面的预后，但机构层面的影响尚未得到证实。

METHODS 方法

Using an institutional stepped-wedge implementation study design, we compared lung cancer resection quality between institutions in pre- and post-implementation phases of kit deployment and, within implementing institutions, resections without versus with the kit. Benchmarks included rates of non-examination of lymph nodes (pNX), non-examination of mediastinal lymph nodes and attainment of American College of Surgeons Operative Standard 5.8. We report institution-level adjusted odds ratios (aOR) for attaining quality benchmarks.

采用机构阶梯式楔形实施研究设计，我们比较了各机构在采集盒部署前和部署后的肺癌切除质量，以及在实施机构内，不使用采集盒和使用采集盒的切除质量。基准包括不检查淋巴结(pNX)、不检查纵隔淋巴结和达到美国外科医生学会操作标准5.8。我们报告达到质量基准的机构层面调整优势比(aOR)。

RESULTS 结果  

From 2009-2020, three pre-implementing hospitals had 953 resections; 11 implementing hospitals had 4,013 resections, 58% without and 42% with the kit. Quality was better in implementing institutions, and with kit cases. Compared to pre-implementing institutions, the aOR for pNX was 0.62 (0.49-0.8, P=0.002), non-examination of mediastinal lymph nodes 0.56 (0.47-0.68, P