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

Background: 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. Material and methods: 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 (n = 221). Correlation of treatment delays to survival was evaluated in different categories and by tumor stages. Results: 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 (p = .03) and diagnosis to treatment (p p Conclusion: 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：多国已采用快速诊疗方案以提升患者满意度，但目前尚不明确此类方案是否可改善患者生存结局。 材料与方法：回顾性收集2015—2016年于奥卢大学医院确诊的221例肺癌患者的症状发作、转诊、检查项目及其耗时情况，以及生存数据。针对不同分类及肿瘤分期的患者，评估治疗延迟与生存的相关性。 结果：生存分析显示，全临床路径（从症状出现至接受治疗）时长处于中位数上下的患者，其生存情况无统计学差异。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，转诊至确诊时长高于中位数的患者生存结局得到改善（p=0.03），确诊至治疗时长高于中位数的患者（p p）。 结论：肺癌诊断排查阶段耗时更长并未导致生存结局恶化，提示快速诊疗路径或许无法改善肺癌患者的临床转归。