Norwegian Association for - PowerPoint Presentation

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Norwegian Association for

Cardiothoracic Surgery

Norwegian register for general thoracic surgery.Steinar Solberg, MD, PhD.Department of Cardiothoracic SurgeryRikshospitalet, Norwayssolber@online.no

Thoracic surgery in Norway 2019

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Summary, 2019A high number – total 1562 operations and 748 operations for lung cancer are reported.

A higher proportion of females (34.8 %) than males (28.1 %) are operated by thoracoscopy for lung cancer (p=0.000). The proportion of lung cancer operations has increased steadily from 37.0 % in 2010 to 47.9 % of the total numbers of operations in 2019.

The female predominance in surgery for lung cancer increased from 53 % in 2018 to 56 % in 2019.Robotic surgery is offered at AHUS, Haukeland and in Tromsø.Two hospitals have a low number lung cancer operations.Norwegian Association for Cardiothoracic Surgery

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Outstandingly low mortality in surgery for lung cancer.30 days mortality: 0.6 % (four deaths in 718 operations)A high proportion (22 %) of lung cancer patients are operated. In addition 7 % are treated with stereotactic radiation and 8 % with fractioned radiation. Thus 37 % are treated with intention to cure.In surgery, 49.5 % are operated by minimally invasive technique (thoracoscopy or robot). This varies from 0 to 85.7 % between the hospitals. Three hospitals has a too low (< 40 %) proportion of the operations performed mini invasively.

The 5 year relative survival in those operated is high (65.0 %) and varies from 57.8 % to 72.2 % between the hospitals.Practically all (99.9 %) of the operations are reported, but in too many hospitals the reports are send very late – up to median 286 days after surgery. Such delay may jeopardise the quality of the data.The removal of lymph nodes in surgery is disappointingly low.

Synopsis from

The Cancer Registry of Norway, 2019

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The quality of lung cancer surgery is very high. Though, some improvements may be suggested: Three hospitals should increase the use of minimally invasive technique.

The time from surgery to reporting to The Cancer Registry should be reduced markedly by several hospitals.More lymph node stations should be operated out.All hospitals should meet the criteria set by the national health authorities.

Norwegian Association for Cardiothoracic Surgery

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Norwegian Association for Cardiothoracic Surgery

Number

of general thoracic operations reported

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Norwegian Association for

Cardiothoracic

Surgery

Number of operations per hospital per year

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Norwegian Association for Cardiothoracic Surgery

Accesses used

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Norwegian Association for Cardiothoracic Surgery

Underlying diagnoses

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Norwegian Association for Cardiothoracic Surgery

Organ operated upon

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Norwegian Association for Cardiothoracic Surgery

Selected

operations performed

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Norwegian Association for Cardiothoracic Surgery

Number of operations for lung metastases performed annually

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Norwegian Association for

Cardiothoracic

Surgery

Operations for lung cancer*

The Cancer

Registry

has

registerted

718

operations

in 2019

*

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Norwegian Association for

Cardiothoracic

Surgery

Number of operations for lung cancer per hospital per year

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Norwegian Association for Cardiothoracic Surgery

Prosedures performed in operations for lung cancer

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Norwegian Association for Cardiothoracic Surgery

The

number

(bars) and percentage (line) of operationsfor lung cancer performed by VATS or RATS (robot)43 operations

performed

by RATS in 2019

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Norwegian Association for Cardiothoracic Surgery

Operations for

lung

cancer performed by robot

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From

the

Cancer Registry of Norway, 2019

Figure 3.13The percentage of resections for lung cancer performed bythoracoscopy (VATS) and byRobot assisted thoracic surgery

(RATS)

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Norwegian Association for Cardiothoracic Surgery

The

percentage

of patiens beeing females in surgery for lung cancer

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Norwegian Association for Cardiothoracic Surgery

Per cent

operated

for lung cancerby thoracoscopy 2010 - 2019 (n=6377)

*

Difference

between

the

sexes

: p = 0.000 (Pearson chi2)

*

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Norwegian Association for Cardiothoracic Surgery

The number (bars) and percentage (line) of patients

operated for lung cancer being 80 years or older

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Norwegian Association for Cardiothoracic Surgery

The number

of operation for lung cancer as proportion

of the total number of operations in general thoracic surgery

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http://www.kreftregisteret.no/

The Cancer

Registry

of Norway Figure 3.15Five year relative survival after surgery 2015-2019.

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Figure 1.1

The indicators for quality for the treatment and the reporting to The Cancer Registry.

From The Cancer Registry

of Norway, 2019

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Figure 3.19

One and five year relative survival for all patients diagnosed with lung cancer per year.

From

The Cancer Registry of Norway, 2019

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Figure 3.20

The median survival (in months) for all patients diagnosed with lung cancer per year.

From

The Cancer Registry of Norway, 2019

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From The Cancer Registry

of

Norway, 2019

Figure 5.4The proportion of the operations that are reported and the median time (in days) from surgery to reporting.

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From The Cancer Registry

of

Norway, 2019

Figure 1.2 The “flow” for patients operated for lung cancer in 2019. From left: the 1-year relative survival for all patients with lung cancer in the respective hospital areas, the proportion operated, the flow from local hospitals to hospitals performing the surgery, the 30 days mortality and 1-year relative survival for those operated.

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Figure

3.12

The mean number of lymph nodes reported removed in surgery – either by «biopsy from nodes», «removal of hole lumph nodes» og by «complete removal

of lymph node stations».

From T

he

Cancer

Registry

of

Norway,

2019

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Figure

3.9

The proportion of the patients given curative treatmet – surgery, stereotactic radiation or fractionated radiotherapy.

From The Cancer Registry of

Norway,

2019

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Figure

3.14

. 30 days mortality after surgery for lung cancer

From The Cancer Registry of Norway, 2019

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T H A N K Y O U