Delaying Surgery Linked to Worse Outcomes for NSCLC

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by Healthday

Risk for recurrence increased with surgical delay beyond 12 weeks; overall survival improved with surgery within 12 weeks

WEDNESDAY, June 2, 2021 (HealthDay News) — For patients with non-small cell lung cancer (NSCLC), delaying surgical procedures for more than 12 weeks is associated with an increased risk for recurrence and worse survival, according to a study published online May 27 in JAMA Network Open.

Brendan T. Heiden, M.D., from Washington University School of Medicine in St. Louis, Missouri, and colleagues conducted a retrospective cohort study to quantify surgical treatment delay and examine its correlation with oncologic outcomes in a cohort of 9,904 patients with clinical stage I NSCLC.

In the cohort, the mean time to surgery (TTS) was 70.1 days. The researchers found that TTS was not associated with an elevated risk for pathologic upstaging or positive margins. With a median follow-up of 6.15 years, 42 percent of patients had recurrence. An increased risk for recurrence was seen in association with factors including younger age, higher Charlson Comorbidity Index score, segmentectomy or wedge resection versus lobectomy, and longer TTS, with increasing risk after 12 weeks. The hazard for recurrence increased significantly for each week of surgical delay beyond 12 weeks (hazard ratio, 1.004). Significantly better overall survival was seen for patients with surgical treatment within 12 weeks of diagnosis versus those with procedures delayed more than 12 weeks (hazard ratio, 1.132).

“Efforts to minimize delays in surgical procedures for lung cancer are essential to decrease the risk of disease recurrence and the associated worse prognosis. Such endeavors are particularly important in the face of compromised access to care during the ongoing COVID-19 pandemic,” the authors write.

Two authors disclosed ties to the biotechnology and medical device industries; one author has a patent pending.

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