Non-small cell lung cancer: time to treatment and survival
For one study, researchers sought to determine how long delaying treatment for stage III-IV non-small cell lung cancer affected patient survival. Cox regression analysis with penalized smoothing splines was used to examine the relationship between treatment delay and all-cause mortality for stage III-IV lung adenocarcinoma and squamous cell carcinoma using data from the National Lung Screening Trial (NLST) and the National Cancer Database (NCDB). ). The NCDB compared cumulative survival in patients who received “early” versus “delayed” treatment using paired propensity score analyzes (i.e., 0-30 versus 90-120 days after diagnosis). According to Cox regression analysis of the NLST (n=392) and NCDB (n=275,198), the relative risk decreased the longer treatment was delayed. There were no significant differences in survival between patients with stage IIIA, IIIB (T3-4, N2, M0), IIIC and IV (M1B-C) adenocarcinoma and patients with adenocarcinoma squamous cell stage IIIA, IIIB, IIIC and IV in a propensity score matched study (all P>0.05). Delay in treatment was related to increased survival in patients with stage IIIB (T1-2, N3, M0) and stage IV (M1A) adenocarcinoma (log-rank P=0.03, P=0.02). The results remained constant in a sensitivity analysis that controlled for wait time bias. In this nationwide study, patients with stage III-IV adenocarcinoma and squamous cell carcinoma who received treatment 3-4 months later had no lower overall survival than those who received treatment immediately. This data could help inform decision-making in the ongoing COVID-19 outbreak.