ArticleTranslational lung cancer research2023
Impact of time-to-treatment on survival for early-stage non-small cell lung cancer in The Netherlands-a nationwide observational cohort study.
Article in Translational lung cancer research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 5 citations in OpenAlex.
- Real-world diagnostic pathways and treatment patterns for suspected lung cancer in Japan: a nationwide claims database analysis.ESMO real world data and digital oncology · 2026Article
- Best supportive care in stage I-III non-small cell lung cancer: survival by reason for curative treatment omission in a real-world study population.Translational lung cancer research · 2026Article
- Contemporary Lung Cancer Nodal Staging and Therapeutic Decision-Making in the 9th TNM Era.Cancers · 2026Review
- Redefining treatment interval in lung cancer surgery in the era of prehabilitation: a systematic review.Translational lung cancer research · 2025Review
- Robotic One Anesthetic Diagnosis and Treatment: A Novel Program for Lung Cancer Care.Annals of thoracic surgery short reports · 2025Article
- Absent preoperative non-small cell lung cancer confirmation and relevant stage migration in the era before neoadjuvant chemoimmunotherapy: implications for treatment decisions in resectable non-small cell lung cancer.Translational lung cancer research · 2025Article
- Quality Indicators for Non-Small Cell Lung Cancer in Queensland, Australia, 2012-2021.Thoracic cancer · 2025Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Varied outcomes on the relation between time-to-treatment and survival in early-stage non-small cell lung cancer (NSCLC) patients are reported. We examined this relation in a large multicentric retrospective cohort study and identified factors associated with extended time-to-treatment. Methods: We included 9,536 patients with clinical stage I-II NSCLC, diagnosed and treated in 2014-2019, from the Netherlands Cancer Registry that includes nation-wide data. Time-to-treatment was defined as the number of days between first outpatient visit for suspected lung cancer and start of treatment. The effect of extended time-to-treatment beyond the first quartile and survival was studied with Cox proportional hazard regression. Analyses were stratified for stage and type of therapy. Time-to-treatment was adjusted for multiple covariates including performance status and socioeconomic status. Factors associated with treatment delay were identified by multilevel logistic regression. Results: Median time-to-treatment was 47 days [interquartile range (IQR): 34-65] for stage I and 46 days (IQR: 34-62) for stage II. The first quartile extended to 33 days for both stages. Risk of death increased significantly with extended time-to-treatment for surgical treatment of clinical stage II patients [adjusted hazard ratio (aHR) >33 days: 1.36, 95% confidence intervals (CI): 1.09-1.70], but not in stage II patients treated with radiotherapy or in stage I patients. Causes of prolonged time-to-treatment were multifactorial including diagnostic tests, such as endoscopic ultrasound (EUS) or endobronchial ultrasound (EBUS). Conclusions: Clinical stage II patients benefit from fast initiation of surgical treatment. Surprisingly this appears to be accounted for by patients who are clinically stage II but pathologically stage I. Further study is needed on characterizing these patients and the significance of lymph node- or distant micrometastasis in guiding time-to-treatment and treatment strategy.
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