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Impact of Timing of Lobectomy on Survival for Clinical Stage IA Lung Squamous Cell Carcinoma.

Publication ,  Journal Article
Yang, C-FJ; Wang, H; Kumar, A; Wang, X; Hartwig, MG; D'Amico, TA; Berry, MF
Published in: Chest
December 2017

BACKGROUND: Because the relationship between the timing of surgery following diagnosis of lung cancer and survival has not been precisely described, guidelines on what constitutes a clinically meaningful delay of resection of early-stage lung cancer do not exist. This study tested the hypothesis that increasing the time between diagnosis and lobectomy for stage IA squamous cell carcinoma (SCC) would be associated with worse survival. METHODS: The association between timing of lobectomy and survival for patients with clinical stage IA SCC in the National Cancer Data Base (2006-2011) was assessed using multivariable Cox proportional hazards analysis and restricted cubic spline (RCS) functions. RESULTS: The 5-year overall survival of 4,984 patients who met study inclusion criteria was 58.3% (95% CI, 56.3-60.2). Surgery was performed within 30 days of diagnosis in 1,811 (36%) patients, whereas the median time to surgery was 38 days (interquartile range, 23, 58). In multivariable analysis, patients who had surgery 38 days or more after diagnosis had significantly worse 5-year survival than patients who had surgery earlier (hazard ratio, 1.13 [95% CI, 1.02-1.25]; P = .022). Multivariable RCS analysis demonstrated the hazard ratio associated with time to surgery increased steadily the longer resection was delayed; the threshold time associated with statistically significant worse survival was ∼90 days or greater. CONCLUSIONS: Longer intervals between diagnosis of early-stage lung SCC and surgery are associated with worse survival. Although factors other than the timing of treatment may contribute to this finding, these results suggest that efforts to minimize delays beyond those needed to perform a complete preoperative evaluation may improve survival.

Duke Scholars

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Published In

Chest

DOI

EISSN

1931-3543

Publication Date

December 2017

Volume

152

Issue

6

Start / End Page

1239 / 1250

Location

United States

Related Subject Headings

  • United States
  • Time-to-Treatment
  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Prognosis
  • Pneumonectomy
  • Operative Time
  • Neoplasm Staging
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Yang, C.-F., Wang, H., Kumar, A., Wang, X., Hartwig, M. G., D’Amico, T. A., & Berry, M. F. (2017). Impact of Timing of Lobectomy on Survival for Clinical Stage IA Lung Squamous Cell Carcinoma. Chest, 152(6), 1239–1250. https://doi.org/10.1016/j.chest.2017.07.032
Yang, Chi-Fu Jeffrey, Hanghang Wang, Arvind Kumar, Xiaofei Wang, Matthew G. Hartwig, Thomas A. D’Amico, and Mark F. Berry. “Impact of Timing of Lobectomy on Survival for Clinical Stage IA Lung Squamous Cell Carcinoma.Chest 152, no. 6 (December 2017): 1239–50. https://doi.org/10.1016/j.chest.2017.07.032.
Yang C-FJ, Wang H, Kumar A, Wang X, Hartwig MG, D’Amico TA, et al. Impact of Timing of Lobectomy on Survival for Clinical Stage IA Lung Squamous Cell Carcinoma. Chest. 2017 Dec;152(6):1239–50.
Yang, Chi-Fu Jeffrey, et al. “Impact of Timing of Lobectomy on Survival for Clinical Stage IA Lung Squamous Cell Carcinoma.Chest, vol. 152, no. 6, Dec. 2017, pp. 1239–50. Pubmed, doi:10.1016/j.chest.2017.07.032.
Yang C-FJ, Wang H, Kumar A, Wang X, Hartwig MG, D’Amico TA, Berry MF. Impact of Timing of Lobectomy on Survival for Clinical Stage IA Lung Squamous Cell Carcinoma. Chest. 2017 Dec;152(6):1239–1250.

Published In

Chest

DOI

EISSN

1931-3543

Publication Date

December 2017

Volume

152

Issue

6

Start / End Page

1239 / 1250

Location

United States

Related Subject Headings

  • United States
  • Time-to-Treatment
  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Prognosis
  • Pneumonectomy
  • Operative Time
  • Neoplasm Staging