Management of Lung Nodules and Lung Cancer Screening During the                     COVID-19 Pandemic: CHEST Expert Panel Report

Mazzone, Peter J.; Gould, Michael K.; Chen, Alexander C.; Choi, Humberto; Detterbeck, Frank C.; Farjah, Farhood; Fong, Kwun M.; Iaccarino, Jonathan M.; Janes, Sam M.; Kanne, Jeffrey P.; Kazerooni, Ella A.; MacMahon, Heber; Naidich, David P.; Powell, Charles A.; Raoof, Suhail; Rivera, M. Patricia; Tanner, Nichole T.; Tanoue, Lynn K.; Tremblay, Alain; Vachani, Anil; White, Charles S.; Wiener, Renda Soylemez; Silvestri, Gerard A.

doi:10.1148/rycan.2020204013

Cited by 53 publications

(61 citation statements)

References 11 publications

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“…Nevertheless, there is a lack of studies examining the diagnosis of lung cancer and treatment guidelines during an epidemic. During the COVID-19 pandemic, several international societies presented guidelines for cancer diagnosis and treatments based on expert opinions [ 14 ]. However, these guidelines are not yet evidence-based.…”

Section: Discussionmentioning

confidence: 99%

Collateral effects of the coronavirus disease 2019 pandemic on lung cancer diagnosis in Korea

et al. 2020

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Background The COVID-19 pandemic is predicted to significantly affect patients with lung cancer, owing to its rapid progression and high mortality. Studies on lung cancer diagnosis and treatment during an epidemic are lacking. We analyzed the impact of COVID-19 on lung cancer diagnosis in Korea, where lung cancer incidence continues to rise. Methods The number of newly diagnosed lung cancer cases in three university-affiliated hospitals during the pandemic and their clinical features were compared with lung cancer cases diagnosed during the same period in the past 3 years. The effectiveness of measures taken by the study hospitals to prevent nosocomial transmission was reviewed. Results A total of 612 patients were diagnosed with lung cancer from February through June, 2017–2020. During the pandemic, the number of patients who sought consultation at the division of pulmonology of study hospitals dropped by 16% from the previous year. Responding to the pandemic, the involved hospitals created physically isolated triage areas for patients with acute respiratory infection symptoms. Wide-range screening and preventive measures were implemented, thus minimizing the delay in lung cancer diagnosis. No patient acquired COVID-19 due to hospital exposure. The proportion of patients with stage III–IV non-small-cell lung cancer (NSCLC) significantly increased (2020: 74.7% vs. 2017: 57.9%, 2018: 66.7%, 2019: 62.7%, p = 0.011). The number of lung cancers diagnosed during this period and the previous year remained the same. Conclusions The proportion of patients with advanced NSCLC increased during the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Collateral effects of the coronavirus disease 2019 pandemic on lung cancer diagnosis in Korea

et al. 2020

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“…The ACR provides guidance on safe resumption of routine care as we prepare to welcome patients back [8]. An expert panel also provides recommendations on management of lung nodules during the pandemic [9,10]. However, as much as we have guidance from professional societies, we have to convince patients to trust in our ability to protect them before elective service volumes will normalize.…”

Section: -Alexandre Dumasmentioning

confidence: 99%

Defining the Recovery

Carlos¹

2020

Journal of the American College of Radiology

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“…Kumar S et al [9] suggested that in the case of limited surgical resources or high risks associated with perioperative care, NSCLC patients who presented with advanced yet localized disease that was resectable could be treated with speci c, non-surgical management, including chemotherapy, chemoimmunotherapy, radiation therapy, and immunotherapy. A previous consensus statement suggested that during the COVID-19 pandemic, the annual screening exam and treatment of clinical stage I NSCLC should be delayed [10] . The statement also concluded that it could be acceptable to delay the surveillance CT scan for approximately three to six months for patients with an incidentally detected pure GGN of any size, a partially solid lung nodule with a solid component of 6 to 8 mm, or a solid nodule that was less than 8 mm in diameter [10] .…”

Section: Introductionmentioning

confidence: 99%

“…A previous consensus statement suggested that during the COVID-19 pandemic, the annual screening exam and treatment of clinical stage I NSCLC should be delayed [10] . The statement also concluded that it could be acceptable to delay the surveillance CT scan for approximately three to six months for patients with an incidentally detected pure GGN of any size, a partially solid lung nodule with a solid component of 6 to 8 mm, or a solid nodule that was less than 8 mm in diameter [10] . Raskin J et al [11] recommended delaying surgery for up to three months in cases of small-size NSCLC that did not appear to grow rapidly, and the growth rate should be followed with chest CT scans.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of non-small cell lung cancer treatment strategies in a region of China with low-risk for COVID-19

Cheng

2020

Preprint

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Purpose This study analyzed the morbidity and mortality associated with non-small cell lung cancer (NSCLC) and evaluated treatment strategies for it in a low-risk area of COVID-19 in China. Materials and methods: We selected patients admitted to Sichuan Science City Hospital from September 2019 to February 2020 and divided them into experimental and control groups. The treatment strategy was evaluated by patients’ prognosis. Results: 9,010 patients were hospitalized. The total morbidity was 0.699%, of which 0.504% was observed in the control group and 0.991% in the experimental group (P=0.024). The total mortality was 0.999/103, of which 0.630/103 was observed in the control group and 1.413/103 in the experimental group (P=0.322). Therapy discontinuation and cancer progression in the experimental group were significantly higher than the control group (P＜0.001, P=0.007). The treatment methods and prognosis were not significantly different for early-stage patients between the two groups. Late-stage patients in the experimental group experienced significantly lower percentages of non-surgical treatments (P＜0.001), higher percentages of discontinued therapies (P＜0.001), lower percentages for prognosis of wellness (P＜0.001), and higher percentages of cancer progression (P＜0.001) than the control group. Conclusion: NSCLC exhibited significantly higher morbidities during the COVID-19 pandemic. The mortality in the experimental group was slightly higher than the control group, while the difference in cancer progression was significant. It is feasible to perform surgery for early-stage NSCLC patients, and treatment should not be suspended for late-stage patients in regions with low-risk for COVID-19 infection.

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Management of Lung Nodules and Lung Cancer Screening During the COVID-19 Pandemic: CHEST Expert Panel Report

Cited by 53 publications

References 11 publications

Collateral effects of the coronavirus disease 2019 pandemic on lung cancer diagnosis in Korea

Collateral effects of the coronavirus disease 2019 pandemic on lung cancer diagnosis in Korea

Defining the Recovery

Evaluation of non-small cell lung cancer treatment strategies in a region of China with low-risk for COVID-19

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