The Impact of Extended Delayed Surgery for Indolent Lung Cancer or Part-solid Ground Glass Nodules. The Annals of thoracic surgery Mayne, N. R., Elser, H., Lin, B. K., Raman, V., Liou, D., Li, X., D'Amico, T. A., Yang, C. J. 2021


BACKGROUND: During the COVID-19 pandemic, patients with lung cancer may experience treatment delays. The objective of this study was to evaluate the impact of extended treatment delays on survival among patients with stage I typical bronchopulmonary carcinoid (BC), lepidic predominant adenocarcinoma (LPA) or invasive adenocarcinoma with a lepidic component (ADL).METHODS: Using National Cancer Data Base data (2004-2015), multivariable Cox regression analysis with penalized smoothing splines was performed to examine the association between treatment delay and all-cause mortality for stage I BC, LPA and ADL. Propensity score-matched analyses compared the overall survival in patients who received "early" versus "delayed" surgery (i.e. 0-30 versus 90-120 days following diagnosis) across the different histologic subtypes.RESULTS: During the study period, patients with stage I BC (n=4,947), LPA (n=5,340) and ADL (n=6,816) underwent surgery. Cox regression analysis of these cohorts showed a gradual steady increase in the hazard ratio the longer treatment is delayed. However, in propensity score-matched analyses which created cohorts of patients who underwent early and delayed surgery that were well-balanced in patient characteristics, no significant differences in 5-year survival were found between early and delayed surgery for stage I BC (87% [95% CI:77-93] vs 89% [95% CI:80-94]), stage I LPA (73% [95% CI:64-80] vs 77% [95% CI:68-83]) and stage I ADL (71% [95% CI:64-76] vs 69% [95% CI:60-76]).CONCLUSIONS: During the COVID-19 pandemic, for early-stage indolent lung tumors and part-solid ground glass lung nodules, a delay of surgery by 3-4 months following diagnosis can be considered.

View details for DOI 10.1016/j.athoracsur.2021.05.099

View details for PubMedID 34329603