Referral to a cancer center (CC), medical oncologist (MO), and use of systemic treatment (ST) in stage IV non-small cell lung cancer (NSCLC) patients: Comparison of years 2003-2006 and 2010 cohorts in a single Canadian institution.

e19056 Background: Despite evidence for survival improvement, only about 25% of stage IV NSCLC patients receive ST. Factors affecting referral to CC, MO, and use of ST are largely unknown. Methods: Stage IV NSCLC patients in Southern Alberta were identified from the provincial cancer registry. Baseline characteristics, referral to CC and MO, and reasons for referral/treatment decisions, were collected from electronic charts. Multivariate analyses were performed to compare median overall survival (mOS), referral and treatment patterns in two cohorts. Results: 925 patients from 2003-2006 and 261 from 2010 were included (n=1186): median age 68.2 yrs (range 32-96). In 2003-2006, more patients were referred to CC (94.3 vs. 82.8%, p<0.0001), but less received traditional chemotherapy (TC) than in 2010 (22.2 vs. 43.1%, p<0.0001). Referral to CC/MO and use of TC correlated with survival (p<0.0001): mOS 16.0 months in those receiving TC vs. 3.7 months in those not referred to CC. Patients who received TC were youn...