Association between surgical quality metric adherence and overall survival among patients with early-stage non-small cell lung cancer

Surgical resection is the preferred treatment for functionally fit patients diagnosed with early-stage non-small lung cancer. Process-based intraoperative quality metrics are important for optimizing long-term outcomes following curative-intent resection. In a cohort study of 9628 veterans, adherence to intraoperative quality metrics (timely surgery, minimally invasive approach, anatomic resection, adequate lymph node sampling, and negative surgical margin) was associated with improved overall and recurrence-free survival. These findings were validated in a cohort of 107 674 nonveteran patients from the National Cancer Database. The authors conclude that efforts to improve adherence to surgical quality metrics may improve patient outcomes following curative-intent resection of early-stage lung cancer.