Understanding Racial Differences in Lung Cancer Surgery Through a Statewide Quality Collaborative

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Health Disparities Research

Background:

• Persistent racial disparities exist in lung cancer outcomes, including incidence, treatment, and survival.
• Surgical resection is a critical component of lung cancer treatment, necessitating an examination of surgical quality across racial groups.

Purpose of the Study:

• To investigate racial disparities in surgical quality for lung cancer treatment.
• To compare surgical quality metrics between Black and White patients undergoing lung cancer resection.

Main Methods:

• Retrospective analysis of adult lung cancer resection patients (2015-2021) from the Michigan Society of Cardiothoracic Surgeons database.
• Utilized propensity score-weighting to compare surgical quality, including resection extent, lymph node evaluation, 30-day mortality, and readmission rates between Black and White patients.
• Included data from 17 high-volume institutions in Michigan.

Main Results:

• The study included 5073 patients (7% Black, 93% White).
• Black patients had significantly fewer lymph nodes collected and stations sampled compared to White patients (P < 0.0001).
• No significant differences were found in 30-day mortality or readmission rates, but Black patients experienced longer hospital stays (P = 0.01).

Conclusions:

• Black patients received less extensive lymph node evaluation during lung cancer surgery.
• Despite differences in lymph node evaluation, key short-term outcomes were comparable between racial groups.
• Findings highlight persistent disparities in surgical care quality for lung cancer patients.