ArticleThe Annals of thoracic surgery2015
Effects of Delayed Surgical Resection on Short-Term and Long-Term Outcomes in Clinical Stage I Non-Small Cell Lung Cancer.
Article in The Annals of thoracic surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 116 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
116 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- Association between time-to-treatment and outcomes in non-small cell lung cancer: a systematic review.Thorax · 2022Pooled it
- Mortality due to cancer treatment delay: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2020Pooled it
- Guideline
- Effect of an Antiracism Intervention on Racial Disparities in Time to Lung Cancer Surgery.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Trial
- Temporal trends and sociodemographic determinants of time to nephrectomy in localized renal cell cancer.International urology and nephrology · 2026Article
- Perioperative Systemic Therapies in Resectable Non-Small Cell Lung Cancer: Opportunities and Challenges.Journal of clinical medicine · 2026Review
- Social Vulnerability is Associated with Significant Delays to Definitive Surgery for Stages IA to IIIA Non-small Cell Lung Cancer and Consequential Increased Rates of Pathologic Upstaging.Annals of surgical oncology · 2026Article
- Tick-borne rash at the surgical site prior to lung cancer resection: a diagnostic and surgical dilemma case report.AME case reports · 2026Article
- Redefining treatment interval in lung cancer surgery in the era of prehabilitation: a systematic review.Translational lung cancer research · 2025Review
- Association of Hospital Surgical Volume With Outcomes in Resected Stage I Non-Small Cell Lung Cancer.The Journal of surgical research · 2025Article
- Real-world data and clinical experience from over 100,000 multi-cancer early detection tests.Nature communications · 2025Article
- Can we rely on intraoperative bronchoscopic biopsies for surgical decision making? 78 single anesthetic robotic bronchoscopy to anatomic resections.JTCVS open · 2025Article
- Wait times between lung cancer diagnosis and surgery: national trends, disparities, and impact on long-term survival.Journal of thoracic disease · 2025Article
- Lung Cancer Under Siege in Spain: Timeliness, Treatment, and Survival Before and After the COVID-19 Pandemic.Cancers · 2025Article
- Disparity in Treatment Receipt by Race and Treatment Guideline Revision Years for Stage 1A Non-Small Cell Lung Cancer Patients in the US.Journal of racial and ethnic health disparities · 2025Article
- Impact of delayed surgery in differentiated thyroid carcinoma and medullary thyroid carcinoma.Endocrine · 2025Article
- Combining Robotic Navigational Bronchoscopy and Lung Resection Into a Single Anesthetic Event: Cost-Effectiveness, Wait Times, and Outcomes.Annals of thoracic surgery short reports · 2025Article
- Fast-Track Diagnostic Pathway for Lung Cancer Detection: Single-Center Experience.Journal of clinical medicine · 2025Article
- Delays in phases of care from identification to treatment of suspicious lung nodules.JTCVS open · 2025Article
56 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundConflicting evidence currently exists regarding the causes and effects of delay of care in non-small cell lung cancer (NSCLC). We hypothesized that delayed surgery in early-stage NSCLC is associated with worse short-term and long-term outcomes.
methodsTreatment data of clinical stage I NSCLC patients undergoing surgical resection were obtained from the National Cancer Data Base (NCDB). Treatment delay was defined as resection 8 weeks or more after diagnosis. Propensity score matching for patient and tumor characteristics was performed to create comparable groups of patients receiving early (less than 8 weeks from diagnosis) and delayed surgery. Multivariable regression models were fitted to evaluate variables influencing delay of surgery.
resultsFrom 1998 to 2010, 39,995 patients with clinical stage I NSCLC received early surgery, while 15,658 patients received delayed surgery. Of these, 27,022 propensity-matched patients were identified. Those with a delay in care were more likely to be pathologically upstaged (18.3% stage 2 or higher versus 16.6%, p < 0.001), have an increased 30-day mortality (2.9% vs 2.4%, p = 0.01), and have decreased median survival (57.7 ± 1.0 months versus 69.2 ± 1.3 months, p < 0.001). Delay in surgery was associated with increasing age, non-white race, treatment at an academic center, urban location, income less than $35,000, and increasing Charlson comorbidity score (p < 0.0001 for all). Delayed patients were more likely to receive a sublobar resection (17.2% vs 13.1%, p < 0.001).
conclusionsPatients receiving delayed resection for clinical stage I NSCLC have higher comorbidity scores that may affect ability to perform lobectomy and result in higher perioperative mortality. However, delay in resection is independently associated with increased rates of upstaging and decreased median survival. Strategies to minimize delay while medically optimizing higher risk patients are needed.
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