For a study, the researchers wanted to determine how time from diagnosis to treatment (TTI) affected viability in patients with non-metastatic non–small-cell lung cancer (NSCLC). Between 2004 and 2013, the National Cancer Database was searched for diagnosed with stage 1 to 3 NSCLC. Patients with unidentified TTI, lacking survivorship status/time, or receiving palliative treatment were omitted. To evaluate agreements and survival outcomes, multivariable Cox proportional hazards modeling, recursive partitioning analysis, and logistic regression were used.
In total, 1,393,232 patients met the eligibility criteria. The average period of follow-up has been 36 months. Between 2004 and 2013, the median TTI increased from 35 to 39 days (P<.001).
TTI groups 31 to 60 days, 61 to 90 days, and greater than 90 days had lower overall survival (OS) particularly in comparison to TTI 1 to 30 days (hazard ratios of 1.04, 1.10, and 1.14; 95% CI, 1.02-1.06, 1.07-1.12, and 1.11-1.17, respectively; P <.001 for all). Recursive partitioning study indicates that TTI of less than equal to 45 days has been the most optimized survivorship criterion (P<.001); patients with TTI less than or equal to 45 days had an average OS of 70.2 months (95% CI, 69.3-71.1 months) vs 61.5 months (95% CI, 60.5-62.4) (P.001). For delayed (> 45 days) TTI, there were substantial differences by age, racial group, nationality, and earnings (P<.001 for all). Subpopulations findings show that stage 1 and 2 patients with TTI less than 45 days had a higher mortality rate than TTI 45 days (hazard ratios, 1.15 and 1.05; 95% CI, 1.12-1.17 and 1.01-1.09, respectively) (P<.001) and 1.01-1.09, respectively) (P < .001).
In non-metastatic NSCLC, a higher TTI is linked to a shorter survival time. TTI less than or equal to 45 days is a clinically targetable time frame that has been linked to better results in patients with lung cancer who are having definitive therapy.