Clinical Report: Assessing Longitudinal Performance Trends in Lung Cancer Surgery

Overview

This study analyzes performance trends in lung cancer surgery across 148 French hospitals from 2020 to 2024, revealing significant variability in postoperative outcomes.

Background

Lung cancer surgery is critical for improving survival rates, yet it carries substantial risks of complications and mortality. This study provides insights into performance trends using a national database.

Data Highlights

Key Findings

• The study included 56,299 patients across 148 hospitals.
• Predictive models showed excellent discrimination with a mean ROC curve of 0.890.
• Performance inertia was observed with persistence probabilities ≥78%.
• Medium-volume hospitals achieved the best improvement trajectories.
• Some low-volume hospitals experienced a nearly ninefold increase in complication rates.
• A subgroup of high-volume hospitals showed a concerning performance degradation.

Clinical Implications

The findings indicate that surgical volume alone does not guarantee quality outcomes in lung cancer surgery.

Conclusion

This study highlights the variability in performance in lung cancer surgery across hospitals.

Related Resources & Content

1. Akinbobola et al, ASCO Post, 2024 -- Quality Improvements in Lung Cancer Surgery and Tumor Pathology May Extend Survival Postsurgery
2. Impact of Surgical Timing on Patient Outcomes in Early Stage Lung Cancer, 2023
3. Identifying Outlier Hospitals in Post-Pancreatectomy Management, 2021
4. Early and locally advanced non-small-cell lung cancer: ESMO Clinical Practice Guideline, 2025
5. European Respiratory Society and European Society of Thoracic Surgeons guideline, 2025
6. Variability in Outcomes and Hospital Practices for Pneumonectomy in Lung Cancer Management in the Netherlands
7. New ERS/ESGE/ESTS Guideline Advances Endosonography in Lung Cancer Diagnosis and Staging
8. The Society of Thoracic Surgeons Expert Consensus Document on Interventions for Screen-Detected Lung Nodules
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11. The Society of Thoracic Surgeons General Thoracic Surgery Database: 2025 Annual Update - PubMed
12. The French National Cancer Institute (INCa)
13. Robotic-assisted thoracic surgery versus video-assisted thoracic surgery for patients undergoing lung resection: a systematic review and meta-analysis of randomized controlled trials - PubMed
14. Is Less More? A Meta-Analysis of Non-Intubated Versus Intubated VATS for Anatomic Resections in Non-Small Cell Lung Cancer - PubMed
15. Effect of obesity on perioperative outcomes following lung cancer surgery: a systematic review and meta-analysis - PubMed
16. Commission on Cancer lung cancer surgery quality metric and overall survival in a population-based cohort. | Journal of Clinical Oncology