P-326 Queensland Integrated Lung Cancer Outcomes Project (QILCOP): 2000 – 2003

Abstract

Background: Queensland Integrated Lung Cancer Outcomes Project (QILCOP) is a multidisciplinary clinician driven initiative aimed at establishing a statewide prospective lung cancer registry to record methods of diagnosis, histological type, staging procedures, curative or palliative intent of treatment modalities, date and site of relapse for patients with lung cancer throughout the State of Queensland in Australia where there are approximately 1500 incident cases of lung cancer per annum. Methods: The QILCOP data collection process was embedded into routine clinical work-flow to maximise data collection efficiency and minimise clinician demands. Key data elements were chosen with reference to the Australian National Cancer Control Initiative (NCCI) common clinical data set for lung cancer. A specific lung cancer computerised database system was developed to collect this data, at the same time providing computerised visual data support for local institutional multidisciplinary lung cancer clinical conferences to plan patient management. Automated computerised linkage options with other clinical datasets (pathology, imaging etc.) are being explored. Results: From 1/1/2000 - 31/12/2003 data has been collected for more than 2672 patients (2348 non small cell lung cancer (NSCLC) and 324 small cell cancer ((SCLC)) The clinical stage for NSCLC cases were Stage 0 (n=6), IA (360), IB (391), IIA (14), IIIA (191), IIIB (426), IV (731), unknown (273). There were 1802 males, 870 females. The mean age 67 years (range 27- 93 years). Most cases were of performance status 0 and 1. More lung cancers were noted in former smokers than current smokers. Conclusions: Diagnostic modalities: 840 out of 956 fine needle aspiration biopsies were positive in comparison to 1136 out of 1761 diagnostic bronchoscopies. Usage of PET scans have increased reflecting evidence and increasing availability of this modality of staging, and improve the correlation between clinical and surgical staging in those receiving curative intent therapy. Staging practices were assessed in relation to current guidelines. Treatment modalities: The initial treatment modality was surgery in 613, chest radiotherapy in 487, extra-thoracic radiotherapy in 142, chemotherapy in 302, chemoradiation in 142, 15% of 50-59 year olds had surgery compared to 19% in over 80 year olds. Chemotherapy (alone) usage increased from 8.5% to 12.5% of cases between 2000 and 2003. Survival to date is consistent with international benchmarks. Updated data analysis will be presented together with analyses of time trends, diagnostic and staging investigations and treatment outcomes. Thanks to clinical input, QILCOP has enabled large scale multicenter, real time lung cancer clinical outcomes tracking to be embedded into routine clinical practice. Clinical practice and outcomes can be evaluated in light of local factors and evidence based guidelines, and ongoing measurements possible following any change processes