Association of diagnostic delays to survival in lung cancer: single center experience

<b>Background:</b> Rapid diagnostics and treatment approaches have been applied in many countries to enhance patient satisfaction, but it is unknown whether this leads to improvements in survival. <b>Material and methods:</b> Symptoms initiation, referral, and investigations and their timing, and survival were retrospectively collected from all the patients diagnosed for lung cancer at Oulu University Hospital 2015–2016 (<i>n</i> = 221). Correlation of treatment delays to survival was evaluated in different categories and by tumor stages. <b>Results:</b> Survival analysis showed no statistical difference between patients having below or above median time for the whole clinical pathway (from symptoms to treatment). Subsection analysis of the clinical pathway and division of patients by stage showed improved survival for patients having longer than median times in referral to diagnosis (<i>p</i> = .03) and diagnosis to treatment (<i>p</i> p <b>Conclusion:</b> Longer time on diagnostic work-up of lung cancer does not worsen the survival suggesting that fast-track approaches might not improve lung cancer outcomes.

**背景**：目前多国已采用快速诊断与治疗方案以提升患者满意度，但此类方案是否能改善患者生存率尚不明确。
**材料与方法**：本研究回顾性收集了2015至2016年于奥卢大学医院确诊的所有肺癌患者（*n*=221）的症状发作时间、转诊流程、各项检查及其耗时，以及患者生存情况。并按不同分类及肿瘤分期，评估了治疗延迟与生存率之间的相关性。
**结果**：生存分析显示，在整个临床路径（从症状出现到开始治疗）中，耗时高于或低于中位时长的患者之间，生存率无统计学差异。对临床路径进行亚组分析，并按肿瘤分期对患者分组后可见，转诊至确诊阶段耗时长于中位时长的患者（*p*=0.03），以及确诊至治疗阶段耗时长于中位时长的患者，其生存率有所提升。
**结论**：肺癌诊断流程耗时更长并不会降低患者生存率，这提示快速诊疗方案或许无法改善肺癌患者的临床结局。