Does Delaying Time in Cancer Treatment Affect Mortality? A Retrospective Cohort Study of Korean Lung and Gastric Cancer Patients

Abstract

The aim of this study is to investigate the association between delays in surgical treatment and five- and one- year mortality in patients with lung or gastric cancer. The National Health Insurance claims data from 2006 to 2015 were used. The association between time to surgical treatment, in which the cut-off value was set at average time (30 or 50 days), and five year mortality was analyzed using the Cox proportional hazard model. Subgroup analysis was performed based on treatment type and location of medical institution. A total of 810 lung and 2659 gastric cancer patients were included, in which 74.8% of lung and 71.2% of gastric cancer patients received surgery within average. Compared to lung cancer patients who received treatment within 50 days, the five-year (HR 1.826, 95% CI 1.437–2.321) mortality of those who received treatment afterwards was higher. The findings were not significant for gastric cancer based on the after 30 days standard (HR: 1.003, 95% CI: 0.822–1.225). In lung cancer patients, time-to-treatment and mortality risk were significantly different depending on region. Delays in surgical treatment were associated with mortality in lung cancer patients. The findings imply the importance of monitoring and assuring timely treatment in lung cancer patients.

Application Effect and Prognosis of High-Quality Nursing in the Whole Process of Nursing in Lung Cancer Surgery

“…Wang et al showed that good perioperative nursing might boost postoperative recovery of patients and improve prognosis [ 6 ]. Nonetheless, conventional nursing fails to alleviate the patients' adverse emotions and leads to compromised treatment efficacy [ 7 ].…”

“…In view of the shortcomings of chemotherapy, traditional Chinese medicine (TCM), such as acupuncture, TCM herbal compression, and herbal decoction, is encouraged as adjuvant therapy to reduce toxicity of chemotherapy drugs and enhance treatment e cacy [5]. Wang et al showed that good perioperative nursing might boost postoperative recovery of patients and improve prognosis [6]. Nonetheless, conventional nursing fails to alleviate the patients' adverse emotions and leads to compromised treatment e cacy [7].…”

Dynamic monitoring revealed a slightly prolonged waiting time for total gastrectomy during the COVID-19 pandemic without increasing the short-term complications

“…Moreover, we observed a prominent difference in admission patterns before and during the COVID-19 period. Many factors resulted in prolonged preoperative waiting times before the COVID-19 pandemic, such as holidays, underlying diseases, diagnosis level of the hospital at the time, and rotation rate of hospital beds ( 20 , 21 ). However, the delay caused by the COVID-19 pandemic made the previous experience of delayed surgery related to waiting time no longer as effective as before, which varied in different countries with different policies and severity of the local pandemic ( 22 – 24 ).…”

“…Studies in the Netherlands showed that waiting time for any treatment (neoadjuvant chemotherapy or gastrectomy) was not associated with lower overall survival ( 26 ). A study in Asia reported that it was safe to wait for surgery for one–two more weeks ( 21 , 27 ). Since there are no SARS-CoV-2 infected cases in our study, no SARS-CoV-2 infection bias was introduced.…”

Lung Cancer Screening Considerations During Respiratory Infection Outbreaks, Epidemics or Pandemics: An International Association for the Study of Lung Cancer Early Detection and Screening Committee Report

“…Whereas the effects of prolonged curtailing of lung cancer screening have yet to be determined, it is known that delay in diagnosis and treatment of lung cancer affects the survival of patients. [48][49][50] Although only a modest impact on survival may be the case if the pandemic were short-lived, the prolonged pandemic of over 18 months now and the observed reduction in the number of resectable early-stage lung cancers suggest that we will be seeing more advanced lung cancers in the coming months and years with prominent effects on mortality. It is, therefore, crucial to find a solution to continue lung cancer screening even with reduced health care resources, taking into account multiple local, regional, and patient-related factors to provide optimal care.…”