1-year mortality in lung cancer in France according to key timepoints of care pathways

Background It is unclear whether delays in care affect prognosis of patients with lung cancer. The primary objective of this study was to describe the care pathway of patients diagnosed with lung cancer in a French region. Secondary objectives were to identify markers associated with 1) time from im...

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Main Authors: Axelle Rivière, Anne Isabelle Lecuyer, Emeline Laurent, Carole Lefebvre, Thierry Lecomte, Elodie Olivier, Delphine Carmier, Laurent Plantier, Leslie Grammatico-Guillon
Format: Article
Language:English
Published: European Respiratory Society 2022-11-01
Series:ERJ Open Research
Online Access:http://openres.ersjournals.com/content/8/4/00157-2022.full
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author Axelle Rivière
Anne Isabelle Lecuyer
Emeline Laurent
Carole Lefebvre
Thierry Lecomte
Elodie Olivier
Delphine Carmier
Laurent Plantier
Leslie Grammatico-Guillon
author_facet Axelle Rivière
Anne Isabelle Lecuyer
Emeline Laurent
Carole Lefebvre
Thierry Lecomte
Elodie Olivier
Delphine Carmier
Laurent Plantier
Leslie Grammatico-Guillon
author_sort Axelle Rivière
collection DOAJ
description Background It is unclear whether delays in care affect prognosis of patients with lung cancer. The primary objective of this study was to describe the care pathway of patients diagnosed with lung cancer in a French region. Secondary objectives were to identify markers associated with 1) time from imaging to treatment and 2) with 1-year survival. Methods In a retrospective cohort study, clinical data from multidisciplinary team meetings for all incident lung cancer cases discussed in 2018 in one French region were matched with medico-administrative data from the National Health Insurance Database. Care pathway time intervals were estimated for small cell lung cancer (SCLC), resected nonsmall cell lung cancer (NSCLC) and unresected NSCLC. Factors associated with delay in the care pathway were identified using linear regression; 1-year survival was analysed using Cox modelling. Results A total of 685 patients were included. Median time between imaging and treatment was 49 days (interquartile range: 33–73), and was lower in cases of metastatic disease, SCLC and private care. At 1 year, 48% had died (resected NSCLC 12%). In unresected NSCLC, time from diagnostic imaging to first treatment <49 days was associated with a higher risk of death. Time intervals were similar in patients with squamous cell carcinoma versus adenocarcinoma or undifferentiated carcinoma. Discussion Time intervals in the care pathways of lung cancer were similar to previous reports, confirming the robustness of retrospective databases. In unresectable NSCLC, rapid care was not associated with better survival.
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spelling doaj.art-6a93b7a3dce441c3a4e7d1994ec992872023-06-07T13:30:37ZengEuropean Respiratory SocietyERJ Open Research2312-05412022-11-018410.1183/23120541.00157-202200157-20221-year mortality in lung cancer in France according to key timepoints of care pathwaysAxelle Rivière0Anne Isabelle Lecuyer1Emeline Laurent2Carole Lefebvre3Thierry Lecomte4Elodie Olivier5Delphine Carmier6Laurent Plantier7Leslie Grammatico-Guillon8 Department of Pulmonology and Pulmonary Function Testing, Teaching Hospital of Tours, Tours, France Public Health Unit, Epidemiology, Centre-Val de Loire (EpiDclic), Teaching Hospital of Tours, Tours, France Public Health Unit, Epidemiology, Centre-Val de Loire (EpiDclic), Teaching Hospital of Tours, Tours, France OncoCentre, Cancer Network of the Centre-Val de Loire Region, Tours, France Medical school, University of Tours, Tours, France Cancer Coordination Centre, Teaching Hospital of Tours, Tours, France Department of Pulmonology and Pulmonary Function Testing, Teaching Hospital of Tours, Tours, France Department of Pulmonology and Pulmonary Function Testing, Teaching Hospital of Tours, Tours, France Medical school, University of Tours, Tours, France Background It is unclear whether delays in care affect prognosis of patients with lung cancer. The primary objective of this study was to describe the care pathway of patients diagnosed with lung cancer in a French region. Secondary objectives were to identify markers associated with 1) time from imaging to treatment and 2) with 1-year survival. Methods In a retrospective cohort study, clinical data from multidisciplinary team meetings for all incident lung cancer cases discussed in 2018 in one French region were matched with medico-administrative data from the National Health Insurance Database. Care pathway time intervals were estimated for small cell lung cancer (SCLC), resected nonsmall cell lung cancer (NSCLC) and unresected NSCLC. Factors associated with delay in the care pathway were identified using linear regression; 1-year survival was analysed using Cox modelling. Results A total of 685 patients were included. Median time between imaging and treatment was 49 days (interquartile range: 33–73), and was lower in cases of metastatic disease, SCLC and private care. At 1 year, 48% had died (resected NSCLC 12%). In unresected NSCLC, time from diagnostic imaging to first treatment <49 days was associated with a higher risk of death. Time intervals were similar in patients with squamous cell carcinoma versus adenocarcinoma or undifferentiated carcinoma. Discussion Time intervals in the care pathways of lung cancer were similar to previous reports, confirming the robustness of retrospective databases. In unresectable NSCLC, rapid care was not associated with better survival.http://openres.ersjournals.com/content/8/4/00157-2022.full
spellingShingle Axelle Rivière
Anne Isabelle Lecuyer
Emeline Laurent
Carole Lefebvre
Thierry Lecomte
Elodie Olivier
Delphine Carmier
Laurent Plantier
Leslie Grammatico-Guillon
1-year mortality in lung cancer in France according to key timepoints of care pathways
ERJ Open Research
title 1-year mortality in lung cancer in France according to key timepoints of care pathways
title_full 1-year mortality in lung cancer in France according to key timepoints of care pathways
title_fullStr 1-year mortality in lung cancer in France according to key timepoints of care pathways
title_full_unstemmed 1-year mortality in lung cancer in France according to key timepoints of care pathways
title_short 1-year mortality in lung cancer in France according to key timepoints of care pathways
title_sort 1 year mortality in lung cancer in france according to key timepoints of care pathways
url http://openres.ersjournals.com/content/8/4/00157-2022.full
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