Chest
Original Research: Lung CancerImpact of Timing of Lobectomy on Survival for Clinical Stage IA Lung Squamous Cell Carcinoma
Section snippets
NCDB
Data from the NCDB, which is a joint project of the American College of Surgeons Commission on Cancer and the American Cancer Society, was used in this study. The NCDB contains data from more than 30 million patients and 1,500 cancer centers in the United States and contains more than 70% of all newly diagnosed cases of cancer in the United States annually.12 All clinical staging information was directly recorded in the NCDB using American Joint Committee on Cancer, sixth13 and seventh editions’
Results
The study cohort consisted of 4,984 patients who underwent lobectomy for clinical stage IA (cT1, N0, M0) lung SCC at least 1 day after diagnosis of lung cancer (Fig 1). Median time to surgery was 38 days (interquartile range [IQR], 24, 60) and 95% of patients underwent surgery within 4 months of diagnosis. Table 1 details the preoperative baseline characteristics and perioperative outcomes stratified by whether surgery was performed before or after the median delay of 38 days. Table 2 shows the
Discussion
This study examined the relationship between timing of lobectomy following diagnosis of lung SCC and overall survival for clinical stage IA patients. Our study found that the median delay between diagnosis and surgery in the NCDB was 38 days. Patients whose surgery was 38 or more days after diagnosis were found to have worse survival in both univariable and multivariable analysis. When we characterized the nonlinear relationship between timing of lobectomy and survival using restricted cubic
Acknowledgments
Author contributions: C. J. Y. is the guarantor of the paper and takes responsibility for the integrity of the work as a whole. C. J. Y., H. W., and A. K. contributed equally in literature search, figures, study design, data collection, data analysis, interpretation and writing, and revisions. X. W. contributed to analyzing and interpreting the data as well as revisions. T. A. D., M. G. H., and M. F. B. contributed to design, data analysis, and interpretation and revisions.
References (45)
Prognostic implications of treatment delays in the surgical resection of lung cancer
Thoracic Surg Clin
(2013)- et al.
Influence of delays on survival in the surgical treatment of bronchogenic carcinoma
Lung Cancer
(2002) - et al.
Time to treatment as a quality metric in lung cancer: staging studies, time to treatment, and patient survival
Radiother Oncol
(2015) - et al.
Survival after community diagnosis of early-stage non-small cell lung cancer
Amer J Med
(2014) - et al.
Effects of delayed surgical resection on short-term and long-term outcomes in clinical stage i non-small cell lung cancer
Ann Thoracic Surg
(2015) - et al.
2nd ESMO Consensus Conference on Lung Cancer: early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up
Ann Oncol
(2014) - et al.
Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines
Chest
(2013) - et al.
International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung adenocarcinoma
J Thoracic Oncol
(2011) - et al.
Are we achieving the current waiting time targets in lung cancer treatment? Result of a prospective study from a large United kingdom teaching hospital
J Thoracic Oncol
(2007) - et al.
Risk factor analysis of locoregional recurrence after sublobar resection in patients with clinical stage IA non-small cell lung cancer
J Thoracic Cardiovasc Surg
(2013)
The 2015 World Health Organization Classification of Lung Tumors: impact of genetic, clinical and radiologic advances since the 2004 classification
J Thoracic Oncol
Lung cancer in women: age, smoking, histology, performance status, stage, initial treatment and survival. Population-based study of 20 561 cases
Ann Oncol
Rapid disease progression with delay in treatment of non-small-cell lung cancer
Inte J Radiat Oncol Biol Phys
The impact of time between staging PET/CT and definitive chemo-radiation on target volumes and survival in patients with non-small cell lung cancer
Radiother Oncol
Outcome in patients with lung cancer found on lung cancer mass screening roentgenograms, but who did not subsequently consult a doctor
Lung Cancer
Does treatment delay affect survival in non-small cell lung cancer? A retrospective analysis from a single UK centre
Lung Cancer
Outcome in patients with lung cancer found retrospectively to have had evidence of disease on past lung cancer mass screening roentgenograms
Lung Cancer
Relationship between delayed diagnosis and the degree of invasion and survival in lung cancer
J Clin Epidemiol
Delays in the diagnosis and treatment of lung cancer
Chest
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: A population-based study
Cancer Epidemiol
Effect of preoperative delay on prognosis for patients with early stage non-small cell lung cancer
J Thoracic Cardiovasc Surg
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FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.