The impact of the COVID-19 pandemic on the surgical treatment of lung cancer

153 Background: Patients’ geographic location can impact access to specialty care and affect the appropriateness and timeliness of evaluation leading to primary surgical treatment of lung cancer. Cancer care coordination has long been speculated to lead to greater efficiency in oncologic care, yet objective measures demonstrating the utility of such healthcare team members is lacking. We aimed to study the impact of patients’ residence on healthcare encounters, travel burden and the distribution of physiologic and oncologic workup leading to delays in care at a specialty cancer center. Methods: We conducted a single center retrospective cohort study of 103 patients undergoing workup of primary lung cancer between January 2015 and August 2017. The shortest route between patient residence and treating medical center was measured in miles and classified as: urban ( < 40 miles); rural (40.1 – 100 miles); and regional (100.1 – 1,000 miles). Average total miles traveled (i.e. travel burden), total number of healthcare encounters, and the distribution of physiologic and oncologic evaluations as drivers of delay in care were examined. Results: Patients were categorized as urban n = 80 (77.7%); rural n = 12 (11.7%); and regional n = 11 (10.7%). Median travel burden (urban = 100 miles [interquartile range, IQR 56-216.8]; rural = 385.7 [127.1 – 769]; regional = 780 [560 – 1936]; p < 0.001) and median total healthcare encounters (urban = 7 [6-9]; rural = 9 [7-9.5]; regional = 10 [7-12]; p = 0.3) increased with greater distance of patient residence from treating medical center. Additional necessary physiologic workup was associated with delayed care and greater burden in the rural and regional patients compared to those residing in urban locations (urban = 21% increase; rural = 152%; regional = 162%). Additional oncologic workup was associated with delayed care in the regional group only (49% increase). These trends remained even when controlling for clinical stage. Conclusions: These findings demonstrate the need for better cancer care coordination for rural and regional lung cancer patients to improve efficiency, appropriateness and timeliness of care while decreasing patient-related burdens.

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P2.13-09 The Impact of the 8th Edition of IASLC Staging in Patients Who Underwent Surgical Treatment of Lung Cancer

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2019.08.1780 ◽

2019 ◽

Vol 14 (10) ◽

pp. S827

Author(s):

P.H. Leite ◽

M. Soares ◽

P. Costa ◽

P. Pêgo Fernandes ◽

R. Terra

Keyword(s):

Lung Cancer ◽

Surgical Treatment ◽

The Impact ◽

8Th Edition

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Delay to surgical treatment in lung cancer patients and its impact on survival in a video-assisted thoracoscopic lobectomy cohort

Scientific Reports ◽

10.1038/s41598-021-84162-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Florian Ponholzer ◽

Veronika Kroepfl ◽

Caecilia Ng ◽

Herbert Maier ◽

Florian Kocher ◽

...

Keyword(s):

Lung Cancer ◽

Surgical Treatment ◽

Cancer Patients ◽

Tumor Board ◽

Stage Migration ◽

Lung Cancer Patients ◽

Patient Pathways ◽

Group A ◽

The Impact ◽

Work Up

AbstractPatient pathways from first suspicious imaging until final surgical treatment vary and in some instances cause considerable delay. This study aims to investigate the impact of this delay on survival of lung cancer patients. The institutional database was queried to identify patients with primary lung cancer who were treated with primary surgery. Time intervals were defined as date of first suspicious medical images until date of surgical treatment. All patients received PET-CT staging and tissue confirmation prior to treatment planning in a multidisciplinary tumor board. Patients with unknown date of first contact, follow-up CT-scans of pulmonary nodules, or neoadjuvant therapy were excluded. In total, 287 patients treated between 2009 and 2017 were included for further analysis. Median time between first suspicious medical imaging and surgical therapy was 62 (range 23–120) days and did not differ between male and female patients. Patients were then classified into two groups according to the duration of the medical work-up: group A up to 60 days, and group B from 61 to 120 days. Clinical T and N stages were comparable between the groups. There was no difference in overall survival between the two groups. In the subgroup of cT2 tumors (87 patients), there was a significant survival benefit for patients in group A (p = 0.043), while nodal stages, stage migration, lymphatic vessel invasion, grading and other potentially survival-influencing clinical parameters were comparable between the groups. Delay between diagnosis and treatment of lung cancer may result in dismal outcome. Efforts need to focus on improving and streamlining patient pathways to shorten the delay until surgical treatment to a minimum. Process improvement might be achieved by stringent interdisciplinary work-up and a patient-centered approach.

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Surgery for Lung Cancer and the Consequences for the Swallow

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig13.162 ◽

2016 ◽

Vol 1 (13) ◽

pp. 162-168

Author(s):

Pippa Hales ◽

Corinne Mossey-Gaston

Keyword(s):

Lung Cancer ◽

Treatment Options ◽

Vocal Cord Palsy ◽

Subsequent Treatment ◽

Physiological Reserve ◽

Palliative Phase ◽

And Function ◽

The Impact ◽

Swallow Function

Lung cancer is one of the most commonly diagnosed cancers across Northern America and Europe. Treatment options offered are dependent on the type of cancer, the location of the tumor, the staging, and the overall health of the person. When surgery for lung cancer is offered, difficulty swallowing is a potential complication that can have several influencing factors. Surgical interaction with the recurrent laryngeal nerve (RLN) can lead to unilateral vocal cord palsy, altering swallow function and safety. Understanding whether the RLN has been preserved, damaged, or sacrificed is integral to understanding the effect on the swallow and the subsequent treatment options available. There is also the risk of post-surgical reduction of physiological reserve, which can reduce the strength and function of the swallow in addition to any surgery specific complications. As lung cancer has a limited prognosis, the clinician must also factor in the palliative phase, as this can further increase the burden of an already compromised swallow. By understanding the surgery and the implications this may have for the swallow, there is the potential to reduce the impact of post-surgical complications and so improve quality of life (QOL) for people with lung cancer.

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The Influence of Immunohistochemical Factors of Bone Marrow Micrometastases on Lung Cancer Patient Survival Rate After Surgical Treatment

Polish Journal of Surgery ◽

10.2478/v10035-007-0115-6 ◽

2007 ◽

Vol 79 (12) ◽

Author(s):

Maciej Dancewicz ◽

Janusz Kowalewski ◽

Mariusz Bella ◽

Jan Sir

Keyword(s):

Lung Cancer ◽

Bone Marrow ◽

Surgical Treatment ◽

Survival Rate ◽

Cancer Patient ◽

Lung Cancer Patient ◽

Patient Survival ◽

Bone Marrow Micrometastases ◽

Patient Survival Rate

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Surgical treatment strategy for small-sized, non-small cell lung cancer: A proposed algorithm for limited resection

The Journal of the Japanese Association for Chest Surgery ◽

10.2995/jacsurg.24.1004 ◽

2010 ◽

Vol 24 (7) ◽

pp. 1004-1010 ◽

Cited By ~ 4

Author(s):

Masayoshi Inoue ◽

Masato Minami ◽

Noriyoshi Sawabata ◽

Yoshihisa Kadota ◽

Yasushi Shintani ◽

...

Keyword(s):

Lung Cancer ◽

Surgical Treatment ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Treatment Strategy ◽

Small Cell ◽

Limited Resection ◽

Small Cell Lung

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Do we Need Maintenance Chemotherapy in Advanced NSCLC in the Era of Immune and Targeted Therapy?

Current Cancer Therapy Reviews ◽

10.2174/1573394714666180417160205 ◽

2019 ◽

Vol 15 (1) ◽

pp. 50-55

Author(s):

Ahmed Nagy ◽

Omar Abdel Rahman ◽

Heba Abdullah ◽

Ahmed Negida

Keyword(s):

Lung Cancer ◽

Maintenance Therapy ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Statistical Significance ◽

Small Cell ◽

Maintenance Chemotherapy ◽

Small Cell Lung ◽

The Impact

Background: Although well established for the effective management of hematologic cancers, maintenance chemotherapy has only been recently incorportated as a treatment paradigm for advanced non–small-cell lung cancer. Maintenance chemotherapy aims to prolong a clinically favorable response state achieved after finishing induction therapy which is usually predefined in number before startng treatment. There are 2 modalities for maintenance therapy; continuation maintenance (involving a non-platinum component which was a part of the induction protocol or a targeted agent) and switch maintenance therapy (utilizing a new agent which was not a part of the induction regimen). Methods: The purpose of this article is to review the role of maintenance therapy in the treatment of advanced Non-Small Cell Lung Cancer (NSCLC) and provide a brief overview about induction chemotherapy in NSCLC to address the basis of maintenance therapy as a treatment option. We will also compare the impact of maintenance chemotherapy with the now evolving role of immunotherapy in NSCLC. Results: There have been 4 maintenance studies to date showing prolonged PFS and OS with statistical significance. However, Three out of the four studies (ECOG4599, JMEN, and PARAMOUNT) did not report tumor molecular analysis. As regard Immunotherapy, current data is in favour of strongly an increasing role for immunotherapy in NSCLC. Conclusion: Maintenance therapy in NSCLC continues to be an important therapeutic line to improve outcome in patients with metastatic and recurrent disease.

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