Skip to main content
Grant Details

Grant Number: 5R01CA172253-02 Interpret this number
Primary Investigator: Osarogiagbon, Raymond
Organization: University Of Memphis
Project Title: Dissemination and Implementation of a Corrective Intervention to Improve Mediasti
Fiscal Year: 2014
Back to top


DESCRIPTION (provided by applicant): About 60,000 individuals undergo surgery for lung cancer in the US annually. For these patients, whether, or not, cancer has spread to their lymph nodes is the main determinant of their prognosis and guides post- operative treatment decision-making. Unfortunately, most lung cancer operations done in the US do not provide a sufficient sample of lymph nodes to make an accurate determination of pathologic lymph node stage. Therefore, a larger number of patients die of lung cancer than would have been predicted by their post- operative stage. Examination of the quality of lung cancer surgical resections in the greater Memphis Metropolitan Area reveals close approximation to the US national quality-of-care gap. Deploying a specially designed lymph node specimen collection kit for use in lung cancer resections significantly improves the quality of pathologic lymph node staging and increases the detection of patients with lymph node metastasis. We now want to test the implementation of the routine use of this unique specimen collection kit in the tri-state area of Eastern Arkansas, Northern Mississippi and Western Tennessee, which has the combination of challenging socio-economic demographics and some of the highest lung cancer mortality rates in the US. Based on our prior work, we hypothesize that successful implementation of this surgical lymph node specimen collection kit will improve the quality of pathologic staging of lung cancer and increase the detection of lymph node metastasis in a diverse mix of patients operated on by a diverse mix of surgeons in a diverse mix of institutions. Our objective is to study the implementation process of routine use of this kit in a demographically diverse, high lung cancer incidence region of the US, in order to maximize its impact in future dissemination. We propose to achieve this by performing the following Specific Aims: 1.) Recruit at least 90% of eligible hospitals (those within our defined catchment area with >5 lung resection operations annually) and surgeons to participate in an implementation study of the lymph node specimen collection kit for lung cancer resections; 2.) Evaluate the effectiveness of the kit in surgery performed in a diverse mix of institutions, using a staggered implementation, multiple baseline study design; 3.) Study the implementation process using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Our study will demonstrate the practical possibility of significantly improving the quality and outcomes of surgical lung cancer care across heterogeneity of practice settings. General improvement in pathologic staging will set the stage for future translational work on development of independently prognostic gene and protein expression profiles by optimizing the use of the Tumor, Node, and Metastasis (TNM) staging system, which is currently our best risk stratification system. The ultimate goal of this project i to provide the clinical infrastructure to support future studies of such prognostic molecular signatures that will supplement, and eventually supersede the current TNM staging system.

Back to top


Risk-Adjusted Margin Positivity Rate as a Surgical Quality Metric for Non-Small Cell Lung Cancer.
Authors: Lin C.C. , Smeltzer M.P. , Jemal A. , Osarogiagbon R.U. .
Source: The Annals Of Thoracic Surgery, 2017 Oct; 104(4), p. 1161-1170.
EPub date: 2017-07-12 00:00:00.0.
PMID: 28709665
Related Citations

Survival impact of postoperative therapy modalities according to margin status in non-small cell lung cancer patients in the United States.
Authors: Smeltzer M.P. , Lin C.C. , Kong F.S. , Jemal A. , Osarogiagbon R.U. .
Source: The Journal Of Thoracic And Cardiovascular Surgery, 2017-04-04 00:00:00.0; , .
EPub date: 2017-04-04 00:00:00.0.
PMID: 28483267
Related Citations

Prognostic Value Of National Comprehensive Cancer Network Lung Cancer Resection Quality Criteria
Authors: Osarogiagbon R.U. , Ray M.A. , Faris N.R. , Smeltzer M.P. , Fehnel C. , Houston-Harris C. , Signore R.S. , McHugh L.M. , Levy P. , Wiggins L. , et al. .
Source: The Annals Of Thoracic Surgery, 2017-03-30 00:00:00.0; , .
PMID: 28366464
Related Citations

Evolution in the Surgical Care of Patients With Non-Small Cell Lung Cancer in the Mid-South Quality of Surgical Resection Cohort.
Authors: Faris N.R. , Smeltzer M.P. , Lu F. , Fehnel C.L. , Chakraborty N. , Houston-Harris C.L. , Robbins E.T. , Signore R.S. , McHugh L.M. , Wolf B.A. , et al. .
Source: Seminars In Thoracic And Cardiovascular Surgery, 2017 Spring; 29(1), p. 91-101.
EPub date: 2016-10-14 00:00:00.0.
PMID: 28684006
Related Citations

Comparison Of Prevalence And Types Of Mutations In Lung Cancers Among Black And White Populations
Authors: Campbell J.D. , Lathan C. , Sholl L. , Ducar M. , Vega M. , Sunkavalli A. , Lin L. , Hanna M. , Schubert L. , Thorner A. , et al. .
Source: Jama Oncology, 2017-01-19 00:00:00.0; , .
PMID: 28114446
Related Citations

Improving Post-resection Risk Stratification In Non-small Cell Lung Cancer: 'wit, Whither Wander You?'
Authors: Osarogiagbon R.U. .
Source: Journal Of Thoracic Disease, 2016 Sep; 8(9), p. 2315-2318.
PMID: 27746964
Related Citations

Survival Implications of Variation in the Thoroughness of Pathologic Lymph Node Examination in American College of Surgeons Oncology Group Z0030 (Alliance).
Authors: Osarogiagbon R.U. , Decker P.A. , Ballman K. , Wigle D. , Allen M.S. , Darling G.E. .
Source: The Annals Of Thoracic Surgery, 2016 Aug; 102(2), p. 363-9.
PMID: 27262908
Related Citations

Missed Intrapulmonary Lymph Node Metastasis and Survival After Resection of Non-Small Cell Lung Cancer.
Authors: Smeltzer M.P. , Faris N. , Yu X. , Ramirez R.A. , Ramirez L.E. , Wang C.G. , Adair C. , Berry A. , Osarogiagbon R.U. .
Source: The Annals Of Thoracic Surgery, 2016 Aug; 102(2), p. 448-53.
PMID: 27266421
Related Citations

Prevalence, Prognostic Implications, and Survival Modulators of Incompletely Resected Non-Small Cell Lung Cancer in the U.S. National Cancer Data Base.
Authors: Osarogiagbon R.U. , Lin C.C. , Smeltzer M.P. , Jemal A. .
Source: Journal Of Thoracic Oncology : Official Publication Of The International Association For The Study Of Lung Cancer, 2016 Jan; 11(1), p. e5-16.
PMID: 26762752
Related Citations

Enhancing the Evidence for Behavioral Counseling: A Perspective From the Society of Behavioral Medicine.
Authors: Alcántara C. , Klesges L.M. , Resnicow K. , Stone A. , Davidson K.W. .
Source: American Journal Of Preventive Medicine, 2015 Sep; 49(3 Suppl 2), p. S184-93.
PMID: 26296553
Related Citations

Editorial preface to this special issue "Improving the quality and outcomes of lung cancer care: an interdisciplinary approach".
Authors: Osarogiagbon R.U. .
Source: Translational Lung Cancer Research, 2015 Aug; 4(4), p. 322-6.
PMID: 26380173
Related Citations

Measuring improvement in populations: implementing and evaluating successful change in lung cancer care.
Authors: Yu X. , Klesges L.M. , Smeltzer M.P. , Osarogiagbon R.U. .
Source: Translational Lung Cancer Research, 2015 Aug; 4(4), p. 373-84.
PMID: 26380178
Related Citations

Improving lung cancer outcomes by improving the quality of surgical care.
Authors: Osarogiagbon R.U. , D'Amico T.A. .
Source: Translational Lung Cancer Research, 2015 Aug; 4(4), p. 424-31.
PMID: 26380183
Related Citations

Improving the pathologic evaluation of lung cancer resection specimens.
Authors: Osarogiagbon R.U. , Hilsenbeck H.L. , Sales E.W. , Berry A. , Jarrett R.W. , Giampapa C.S. , Finch-Cruz C.N. , Spencer D. .
Source: Translational Lung Cancer Research, 2015 Aug; 4(4), p. 432-7.
PMID: 26380184
Related Citations

Innovations in public health education: promoting professional development and a culture of health.
Authors: Levy M. , Gentry D. , Klesges L.M. .
Source: American Journal Of Public Health, 2015 Mar; 105 Suppl 1, p. S44-5.
PMID: 25706016
Related Citations

Audit of lymphadenectomy in lung cancer resections using a specimen collection kit and checklist.
Authors: Osarogiagbon R.U. , Sareen S. , Eke R. , Yu X. , McHugh L.M. , Kernstine K.H. , Putnam J.B. , Robbins E.T. .
Source: The Annals Of Thoracic Surgery, 2015 Feb; 99(2), p. 421-7.
PMID: 25530090
Related Citations

The impact of a novel lung gross dissection protocol on intrapulmonary lymph node retrieval from lung cancer resection specimens.
Authors: Osarogiagbon R.U. , Eke R. , Sareen S. , Leary C. , Coleman L. , Faris N. , Yu X. , Spencer D. .
Source: Annals Of Diagnostic Pathology, 2014 Aug; 18(4), p. 220-6.
PMID: 24866232
Related Citations

Size and histologic characteristics of lymph node material retrieved from tissue discarded after routine pathologic examination of lung cancer resection specimens.
Authors: Osarogiagbon R.U. , Ramirez R.A. , Wang C.G. , Miller L.E. , McHugh L. , Adair C.A. , Smeltzer M.P. , Yu X. , Berry A. .
Source: Annals Of Diagnostic Pathology, 2014 Jun; 18(3), p. 136-9.
PMID: 24636044
Related Citations

Number of lymph nodes associated with maximal reduction of long-term mortality risk in pathologic node-negative non-small cell lung cancer.
Authors: Osarogiagbon R.U. , Ogbata O. , Yu X. .
Source: The Annals Of Thoracic Surgery, 2014 Feb; 97(2), p. 385-93.
PMID: 24266949
Related Citations

Back to Top