ACS Collaborative May Improve Compliance in Lung Nodal Assessment

Community programs showed the largest gains in compliance with a surgical staging standard following participation in the Lung NODES collaborative.

By
Andrea Surnit
May 20, 2026
4 min

Conexiant

Objective:

To evaluate the impact of a national quality-improvement collaborative on compliance with lung cancer surgical operative standards across US cancer programs.

Key Findings:

Hospital-level median compliance increased from 68% to 91%.
The number of programs achieving at least 80% compliance rose from 41% to 67%.
Community programs showed the largest compliance increase of 37 percentage points.
74% of patients received compliant care, with higher compliance in integrated network programs and robotic-assisted surgeries.
Failure to perform required lymphadenectomy accounted for 74% of noncompliant cases.

Interpretation:

Participation in the Lung NODES collaborative significantly improved compliance with lymph node assessment standards, indicating the potential effectiveness of national quality improvement initiatives.

Limitations:

Study limited to Commission on Cancer–accredited hospitals, affecting generalizability.
Exclusion of 57 hospitals that did not submit cases during the final collection period.
Lack of data on survival, postoperative complications, nodal upstaging, or systemic therapy use.
Absence of a control group complicates the assessment of improvement attributable to the intervention.