Estimating the Impact of Extended Delay to Surgery for Stage I Non-small-cell Lung Cancer on Survival
The purpose of this study is to evaluate the impact of extended delay to surgery for stage I NSCLC. During the COVID-19 pandemic, patients with NSCLC may experience delays in care, and some national guidelines recommend delays in surgery by >3 months for early NSCLC. Using data from the National...
Gespeichert in:
| Veröffentlicht in: | Annals of surgery 2021-05, Vol.273 (5), p.850-857 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 857 |
|---|---|
| container_issue | 5 |
| container_start_page | 850 |
| container_title | Annals of surgery |
| container_volume | 273 |
| creator | Mayne, Nicholas R. Elser, Holly C. Darling, Alice J. Raman, Vignesh Liou, Douglas Z. Colson, Yolonda L. D’Amico, Thomas A. Yang, Chi-Fu Jeffrey |
| description | The purpose of this study is to evaluate the impact of extended delay to surgery for stage I NSCLC.
During the COVID-19 pandemic, patients with NSCLC may experience delays in care, and some national guidelines recommend delays in surgery by >3 months for early NSCLC.
Using data from the National Lung Screening Trial, a multi-center randomized trial, and the National Cancer Data Base, a multi-institutional oncology registry, the impact of "early" versus "delayed" surgery (surgery received 0-30 vs 90-120 days after diagnosis) for stage I lung adenocarcinoma and squamous cell carcinoma (SCC) was assessed using multivariable Cox regression analysis with penalized smoothing spline functions and propensity score-matched analyses.
In Cox regression analysis of the National Lung Screening Trial (n = 452) and National Cancer Data Base (n = 80,086) cohorts, an increase in the hazard ratio was seen the longer surgery was delayed. In propensity score-matched analysis, no significant differences in survival were found between early and delayed surgery for stage IA1 adenocarcinoma and IA1-IA3 SCC (all P > 0.13). For stage IA2-IB adenocarcinoma and IB SCC, delayed surgery was associated with worse survival (all P < 0.004).
The mortality risk associated with an extended delay to surgery differs across patient subgroups, and difficult decisions to delay care during the COVID-19 pandemic should take substage and histologic subtype into consideration. |
| doi_str_mv | 10.1097/SLA.0000000000004811 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2493459559</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2493459559</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3526-f2fcfa95181c36ffc0a2053f3d122b14dc0a0d6dc0d2cefdf20470e0e5ebcc4c3</originalsourceid><addsrcrecordid>eNpdkE9vEzEQxS3UiqaFb4CQj724Hf_b7B6rkEKliB4C55XjHScB7zrY3rb59jhNC4i5jObpvWfrR8gHDlccmun1cnFzBf-Mqjl_QyZci5pxruCETIoqmWqkOCPnKf0A4KqG6VtyJmUlQUk9IThPedubvB3WNG-Q3vU7YzMNjs6fMg4ddvQTerOnOdDlGNcY99SFSJfZrIubfg0DS73xnln0ni7G0jMzg8VIw3BIPGwfjH9HTp3xCd-_7Avy_Xb-bfaFLe4_381uFsxKLSrmhLPONJrX3MrKOQtGgJZOdlyIFVddEaCryuqERdc5AWoKCKhxZa2y8oJcHnt3MfwaMeW236bDx8yAYUytKDCUbrRuilUdrTaGlCK6dhcLiLhvObQHwG0B3P4PuMQ-vrwwrnrs_oReif7tfQw-Y0w__fiIsd2g8Xlz7Kt0zQQIDroc7FmRvwGNyIXH</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2493459559</pqid></control><display><type>article</type><title>Estimating the Impact of Extended Delay to Surgery for Stage I Non-small-cell Lung Cancer on Survival</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><source>PubMed Central</source><creator>Mayne, Nicholas R. ; Elser, Holly C. ; Darling, Alice J. ; Raman, Vignesh ; Liou, Douglas Z. ; Colson, Yolonda L. ; D’Amico, Thomas A. ; Yang, Chi-Fu Jeffrey</creator><creatorcontrib>Mayne, Nicholas R. ; Elser, Holly C. ; Darling, Alice J. ; Raman, Vignesh ; Liou, Douglas Z. ; Colson, Yolonda L. ; D’Amico, Thomas A. ; Yang, Chi-Fu Jeffrey</creatorcontrib><description>The purpose of this study is to evaluate the impact of extended delay to surgery for stage I NSCLC.
During the COVID-19 pandemic, patients with NSCLC may experience delays in care, and some national guidelines recommend delays in surgery by >3 months for early NSCLC.
Using data from the National Lung Screening Trial, a multi-center randomized trial, and the National Cancer Data Base, a multi-institutional oncology registry, the impact of "early" versus "delayed" surgery (surgery received 0-30 vs 90-120 days after diagnosis) for stage I lung adenocarcinoma and squamous cell carcinoma (SCC) was assessed using multivariable Cox regression analysis with penalized smoothing spline functions and propensity score-matched analyses.
In Cox regression analysis of the National Lung Screening Trial (n = 452) and National Cancer Data Base (n = 80,086) cohorts, an increase in the hazard ratio was seen the longer surgery was delayed. In propensity score-matched analysis, no significant differences in survival were found between early and delayed surgery for stage IA1 adenocarcinoma and IA1-IA3 SCC (all P > 0.13). For stage IA2-IB adenocarcinoma and IB SCC, delayed surgery was associated with worse survival (all P < 0.004).
The mortality risk associated with an extended delay to surgery differs across patient subgroups, and difficult decisions to delay care during the COVID-19 pandemic should take substage and histologic subtype into consideration.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/SLA.0000000000004811</identifier><identifier>PMID: 33630435</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - surgery ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - surgery ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - surgery ; Clinical Decision-Making ; COVID-19 - epidemiology ; Humans ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; Neoplasm Staging ; Pandemics ; Propensity Score ; Proportional Hazards Models ; Retrospective Studies ; SARS-CoV-2 ; Time-to-Treatment</subject><ispartof>Annals of surgery, 2021-05, Vol.273 (5), p.850-857</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3526-f2fcfa95181c36ffc0a2053f3d122b14dc0a0d6dc0d2cefdf20470e0e5ebcc4c3</citedby><cites>FETCH-LOGICAL-c3526-f2fcfa95181c36ffc0a2053f3d122b14dc0a0d6dc0d2cefdf20470e0e5ebcc4c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33630435$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mayne, Nicholas R.</creatorcontrib><creatorcontrib>Elser, Holly C.</creatorcontrib><creatorcontrib>Darling, Alice J.</creatorcontrib><creatorcontrib>Raman, Vignesh</creatorcontrib><creatorcontrib>Liou, Douglas Z.</creatorcontrib><creatorcontrib>Colson, Yolonda L.</creatorcontrib><creatorcontrib>D’Amico, Thomas A.</creatorcontrib><creatorcontrib>Yang, Chi-Fu Jeffrey</creatorcontrib><title>Estimating the Impact of Extended Delay to Surgery for Stage I Non-small-cell Lung Cancer on Survival</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>The purpose of this study is to evaluate the impact of extended delay to surgery for stage I NSCLC.
During the COVID-19 pandemic, patients with NSCLC may experience delays in care, and some national guidelines recommend delays in surgery by >3 months for early NSCLC.
Using data from the National Lung Screening Trial, a multi-center randomized trial, and the National Cancer Data Base, a multi-institutional oncology registry, the impact of "early" versus "delayed" surgery (surgery received 0-30 vs 90-120 days after diagnosis) for stage I lung adenocarcinoma and squamous cell carcinoma (SCC) was assessed using multivariable Cox regression analysis with penalized smoothing spline functions and propensity score-matched analyses.
In Cox regression analysis of the National Lung Screening Trial (n = 452) and National Cancer Data Base (n = 80,086) cohorts, an increase in the hazard ratio was seen the longer surgery was delayed. In propensity score-matched analysis, no significant differences in survival were found between early and delayed surgery for stage IA1 adenocarcinoma and IA1-IA3 SCC (all P > 0.13). For stage IA2-IB adenocarcinoma and IB SCC, delayed surgery was associated with worse survival (all P < 0.004).
The mortality risk associated with an extended delay to surgery differs across patient subgroups, and difficult decisions to delay care during the COVID-19 pandemic should take substage and histologic subtype into consideration.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - surgery</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Clinical Decision-Making</subject><subject>COVID-19 - epidemiology</subject><subject>Humans</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>Neoplasm Staging</subject><subject>Pandemics</subject><subject>Propensity Score</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Time-to-Treatment</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE9vEzEQxS3UiqaFb4CQj724Hf_b7B6rkEKliB4C55XjHScB7zrY3rb59jhNC4i5jObpvWfrR8gHDlccmun1cnFzBf-Mqjl_QyZci5pxruCETIoqmWqkOCPnKf0A4KqG6VtyJmUlQUk9IThPedubvB3WNG-Q3vU7YzMNjs6fMg4ddvQTerOnOdDlGNcY99SFSJfZrIubfg0DS73xnln0ni7G0jMzg8VIw3BIPGwfjH9HTp3xCd-_7Avy_Xb-bfaFLe4_381uFsxKLSrmhLPONJrX3MrKOQtGgJZOdlyIFVddEaCryuqERdc5AWoKCKhxZa2y8oJcHnt3MfwaMeW236bDx8yAYUytKDCUbrRuilUdrTaGlCK6dhcLiLhvObQHwG0B3P4PuMQ-vrwwrnrs_oReif7tfQw-Y0w__fiIsd2g8Xlz7Kt0zQQIDroc7FmRvwGNyIXH</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Mayne, Nicholas R.</creator><creator>Elser, Holly C.</creator><creator>Darling, Alice J.</creator><creator>Raman, Vignesh</creator><creator>Liou, Douglas Z.</creator><creator>Colson, Yolonda L.</creator><creator>D’Amico, Thomas A.</creator><creator>Yang, Chi-Fu Jeffrey</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210501</creationdate><title>Estimating the Impact of Extended Delay to Surgery for Stage I Non-small-cell Lung Cancer on Survival</title><author>Mayne, Nicholas R. ; Elser, Holly C. ; Darling, Alice J. ; Raman, Vignesh ; Liou, Douglas Z. ; Colson, Yolonda L. ; D’Amico, Thomas A. ; Yang, Chi-Fu Jeffrey</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3526-f2fcfa95181c36ffc0a2053f3d122b14dc0a0d6dc0d2cefdf20470e0e5ebcc4c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - surgery</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Clinical Decision-Making</topic><topic>COVID-19 - epidemiology</topic><topic>Humans</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>Neoplasm Staging</topic><topic>Pandemics</topic><topic>Propensity Score</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>Time-to-Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mayne, Nicholas R.</creatorcontrib><creatorcontrib>Elser, Holly C.</creatorcontrib><creatorcontrib>Darling, Alice J.</creatorcontrib><creatorcontrib>Raman, Vignesh</creatorcontrib><creatorcontrib>Liou, Douglas Z.</creatorcontrib><creatorcontrib>Colson, Yolonda L.</creatorcontrib><creatorcontrib>D’Amico, Thomas A.</creatorcontrib><creatorcontrib>Yang, Chi-Fu Jeffrey</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mayne, Nicholas R.</au><au>Elser, Holly C.</au><au>Darling, Alice J.</au><au>Raman, Vignesh</au><au>Liou, Douglas Z.</au><au>Colson, Yolonda L.</au><au>D’Amico, Thomas A.</au><au>Yang, Chi-Fu Jeffrey</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Estimating the Impact of Extended Delay to Surgery for Stage I Non-small-cell Lung Cancer on Survival</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>273</volume><issue>5</issue><spage>850</spage><epage>857</epage><pages>850-857</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><abstract>The purpose of this study is to evaluate the impact of extended delay to surgery for stage I NSCLC.
During the COVID-19 pandemic, patients with NSCLC may experience delays in care, and some national guidelines recommend delays in surgery by >3 months for early NSCLC.
Using data from the National Lung Screening Trial, a multi-center randomized trial, and the National Cancer Data Base, a multi-institutional oncology registry, the impact of "early" versus "delayed" surgery (surgery received 0-30 vs 90-120 days after diagnosis) for stage I lung adenocarcinoma and squamous cell carcinoma (SCC) was assessed using multivariable Cox regression analysis with penalized smoothing spline functions and propensity score-matched analyses.
In Cox regression analysis of the National Lung Screening Trial (n = 452) and National Cancer Data Base (n = 80,086) cohorts, an increase in the hazard ratio was seen the longer surgery was delayed. In propensity score-matched analysis, no significant differences in survival were found between early and delayed surgery for stage IA1 adenocarcinoma and IA1-IA3 SCC (all P > 0.13). For stage IA2-IB adenocarcinoma and IB SCC, delayed surgery was associated with worse survival (all P < 0.004).
The mortality risk associated with an extended delay to surgery differs across patient subgroups, and difficult decisions to delay care during the COVID-19 pandemic should take substage and histologic subtype into consideration.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>33630435</pmid><doi>10.1097/SLA.0000000000004811</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0003-4932 |
| ispartof | Annals of surgery, 2021-05, Vol.273 (5), p.850-857 |
| issn | 0003-4932 1528-1140 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2493459559 |
| source | MEDLINE; Journals@Ovid Complete; PubMed Central |
| subjects | Adenocarcinoma - mortality Adenocarcinoma - surgery Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - surgery Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - surgery Clinical Decision-Making COVID-19 - epidemiology Humans Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - surgery Neoplasm Staging Pandemics Propensity Score Proportional Hazards Models Retrospective Studies SARS-CoV-2 Time-to-Treatment |
| title | Estimating the Impact of Extended Delay to Surgery for Stage I Non-small-cell Lung Cancer on Survival |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-06T13%3A51%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Estimating%20the%20Impact%20of%20Extended%20Delay%20to%20Surgery%20for%20Stage%20I%20Non-small-cell%20Lung%20Cancer%20on%20Survival&rft.jtitle=Annals%20of%20surgery&rft.au=Mayne,%20Nicholas%20R.&rft.date=2021-05-01&rft.volume=273&rft.issue=5&rft.spage=850&rft.epage=857&rft.pages=850-857&rft.issn=0003-4932&rft.eissn=1528-1140&rft_id=info:doi/10.1097/SLA.0000000000004811&rft_dat=%3Cproquest_cross%3E2493459559%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2493459559&rft_id=info:pmid/33630435&rfr_iscdi=true |