Associations Between Time to Treatment Start and Survival in Patients With Lung Cancer

In Vivo. 2021 May-Jun;35(3):1595-1603. doi: 10.21873/invivo.12416.

Abstract

Background: Time-to-treatment is defined as a quality indicator for cancer care but is not well documented. We investigated whether meeting Norwegian timeframes of 35/42 days from referral until start of chemotherapy or surgery/radiotherapy for lung cancer was associated with survival.

Patients and methods: The medical records of 439 lung cancer patients at a regional cancer center were reviewed and categorized according to treatment: (i) surgery; ii) radical radiotherapy; iii) stereotactic radiotherapy; iv) palliative treatment, no cancer symptoms; v) palliative treatment with severe cancer symptoms).

Results: Proportions receiving timely treatment varied significantly at 39%, 48%, 10%, 44% and 89%, respectively (p<0.001). Overall, those starting treatment on time had the shortest median overall survival (10.6 vs. 22.6 months; p<0.001). This was also the case for palliative (5.3 vs. 11.4 months) (p<0.001) but not for curative treatment (not reached vs. 38.3 months) (p=0.038).

Conclusion: Timely treatment is not necessarily associated with improved survival.

Keywords: Quality of healthcare; cancer care; delayed treatment; quality indicator; treatment outcomes.

MeSH terms

  • Humans
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / therapy
  • Neoplasm Staging
  • Palliative Care
  • Time-to-Treatment*