Delaying lung cancer surgery associated with higher risk of
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Swiftness is essential when treating lung cancer. However, some patients postpone surgery. But a new study found that delaying lung cancer surgery for more than 12 weeks from the date of diagnosis with a CT scan is associated with a higher risk of recurrence and death.

This JAMA study was aimed to use a uniform method to quantify surgical treatment delay and to examine its association with several oncologic outcomes.

This retrospective cohort study was conducted using a novel data set from the Veterans Health Administration (VHA) system. Included patients had clinical stage I NSCLC and were undergoing resection. Time to surgical treatment (TTS) was defined as the time between preoperative diagnostic computed tomography imaging and surgical treatment. 9904 patients underwent surgical treatment for clinical stage I NSCLC.

--TTS was not associated with an increased risk of pathologic upstaging or positive margins.

--Recurrence was detected in 4158 patients with a median follow-up of 6.15 years.

--Factors associated with increased risk of recurrence included younger age, higher Charlson Comorbidity Index score, segmentectomy or wedge resection, larger tumor size, higher tumor grade, lower number of lymph nodes examined, higher pathologic stage, and longer TTS, with increasing risk after 12 weeks.

--For each week of surgical delay beyond 12 weeks, the hazard for recurrence increased by 0.4%.

--Factors associated with delayed surgical treatment included African American race, higher area deprivation index [ADI] score, lower hospital caseload, and year of diagnosis, with less recent procedures more likely to have a delay.

--Patients with surgical treatment within 12 weeks of diagnosis had significantly better overall survival than those with procedures delayed more than 12 weeks.

Using a more precise definition for TTS, this study found that surgical procedures delayed more than 12 weeks were associated with increased risk of recurrence and worse survival.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780403
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