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Lung Surgery Patients Experience Better Outcomes when Treated by Thoracic Surgeons

A study on the outcomes of 19,754 lung cancer surgery patients showed that patients who were treated by board-certified thoracic surgeons experienced better long-term outcomes than patients who were treated by non-specialists. The study presented by Farood Farjah, MD, at the annual meeting of the Society of Thoracic Surgeons, is the first to link long-term survival in operable lung cancer with surgeon specialty.

The study was based on the National Cancer Institute’s Surveillance, Epidemiology, and End Results Data, which were linked to the American Board of Thoracic Surgery Diplomates List. The patients in the study received surgery for lung cancer anytime between 1992 and 2002, with follow-up care through 2005. The study designated board-certified thoracic surgeons as either cardiothoracic surgeons (CTS) if they perform cardiac procedures or general thoracic surgeons (GTS) if they do not.

After adjustments for patient, disease and management characteristics, teaching status of the hospital and hospital volume, the study showed that the long-term hazard ratio of death for patients treated by board certified thoracic surgeons was 11 percent lower than those treated by surgeons not board certified in thoracic surgery. Of the 19,754 patients in the study, 4,677 were treated by surgeons not board certified in thoracic surgery, 8,807 patients were treated by CTS, and 6,261were treated by GTS. Patient age, co-morbidity index, and the type of surgery did not vary greatly among the patients.

“The immediate and long-term implication this study will have is in the education and board certification of surgeons who perform thoracic surgery,” said Shahriyour Andaz, MD, Director of Thoracic Oncology at South Nassau Communities Hospital. “Studies continue to demonstrate that the advanced and specialized training and education gained from earning and maintaining board certification is linked to better short- and long-term patient outcomes.”

Dr. Andaz, board certified in both thoracic and general surgery, specializes in complex chest cancer procedures and minimally invasive thorascopic surgery. His expertise includes chest wall sarcoma resection and reconstruction, mesothelioma, tracheal resections and reconstructions, endobronchial surgery, esophageal resection and lung volume reduction surgery. Eliminating the need for large incisions and painful rib resections, the minimally invasive approach offers faster healing and shortened recovery time.

Dr. Andaz has extensive training with elite thoracic surgeons at some of the world's leading medical institutions. Before joining UCLA Medical Center’s Thoracic Surgery Department in 2003, Dr. Andaz was an attending cardiothoracic surgeon from 2001-03 at Brookdale, Coney Island and Lutheran Hospitals and Maimonides Medical Center, where he was a Cardiothoracic Fellow from 1998-2001. Dr Andaz moved to the U.S. after serving as the rotating surgical registrar in general and vascular surgery for Basingstroke District Hospital, University College Hospital and Mount Vernon Hospital in the United Kingdom from 1988-93.

Thoracic Oncology is a division of South Nassau’s Surgical Oncology Program, which also specializes in head, neck, breast and chest tumors; tumors of the female reproductive system; soft tissue sarcoma and melanoma and upper gastrointestinal and colorectal procedures; tracheal, esophageal and liver surgeries; and radio frequency ablation for liver tumors. The program’s surgical oncologists use advanced minimally invasive techniques whenever possible that eliminate the need for large incisions, reduce blood loss during surgery, and lessen the intensity of post-operative pain. They work with similarly-trained medical oncologists and radiation oncologists in comprehensive, multidisciplinary teams to provide evaluation and therapy for a wide range of cancers, both common and rare.

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