The impact of delayed diagnosis of lung cancer on the stage at the time of operation

Christensen, E; Harvald, Thomas; Jendresen, M; Aggestrup, S; Petterson, G

doi:10.1016/s1010-7940(97)00275-3

Cited by 97 publications

(87 citation statements)

References 12 publications

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“…In the work by Billing & Wells (7), total delay was de ned as the time from the rst visit to the general practitioner until surgery, and then further divided into 11 subgroups in order to determine the reasons for the observed delay (see Table 1). In the work by Christensen et al (8), the endpoint was date of operation or the date when it was decided that surgery was not indicated. These are all relevant clinical endpoints, but they are not comparable, as some time must elapse between the decision to operate and the time surgery is actually performed.…”

Section: Doctors' Delaymentioning

confidence: 99%

“…Only one of the studies focused on the association between delay and survival, and for a group of cancer patients, not analysed separately for lung cancer, a signi cantly better rate of survival was found for patients having patient delay than for patients having doctors' delay (10). One study found a signi cantly longer delay for stage III, IV than for stage I, II disease at the pre-hospital, but not at the in-hospital level (8). In another study 6 out of 29 patients became clinically incurable while waiting (9).…”

Section: The Prognostic Impact Of Delaymentioning

confidence: 99%

See 1 more Smart Citation

Impact of Delay on Diagnosis and Treatment of Primary Lung Cancer

Jensen¹,

Mainz²,

Overgaard³

2002

Acta Oncologica

105

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Section: Doctors' Delaymentioning

confidence: 99%

Section: The Prognostic Impact Of Delaymentioning

confidence: 99%

Impact of Delay on Diagnosis and Treatment of Primary Lung Cancer

Jensen¹,

Mainz²,

Overgaard³

2002

Acta Oncologica

105

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“…However, diagnostic and treatment delays continue to remain very common problems among the patients with lung cancer (5)(6)(7)(8). Some studies looking at the impact of delays on tumour stage and survival rate have shown that delays affected tumour stage and survival rate (9)(10)(11). On the other hand, others have reported that delays were not associated with tumour stage and survival rate (5,7,8,12).…”

Section: Introductionmentioning

confidence: 99%

Delays in the Diagnosis and Treatment of Primary Lung Cancer: Are Longer Delays Associated with Advanced Pathological Stage?

Yılmaz¹,

Damadoğlu²,

Saltürk³

et al. 2008

Upsala Journal of Medical Sciences

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We aimed to investigate the delays from the first symptom to thoracotomy and to examine whether the delays cause the stage advancement in lung cancer. This prospective study included 138 patients with non-small cell lung carcinoma who underwent thoracotomy. Clinical files of the patients were analyzed and a questionnaire was created to obtain information from the patients. The mean duration values were 81.3 days for the application interval, 61.3 days for the referral interval, 20.3 days for the diagnostic interval, and 21.9 days for the treatment interval. The application interval was longer than 30 days (patient delay) in 50 patients (37.9 %). The mean interval from the first visit to doctor to thoracotomy was 97.2 days. There was a doctor delay in 102 (73.9 %) patients; a referral delay in 83 patients (60.1 %), a diagnostic delay in 47 patients (36.4 %), and a treatment delay in 96 patients (69.6 %). The mean total duration was 176.2 days. Ninety-four patients (71.2 %) had a total delay. Mean total delay was 184.5 days in pathologic stage I, 187.3 days in stage II, 167.7 days in stage IIIA, 142.6 days in stage IIIB, and 150.3 days in stage IV (p>0.05). Delays during the course between the first symptom and thoracotomy in lung cancer patients were a common problem among our patients. Prolonged durations in the application and referral of patients are the most significant cause of delays. Presence of delay or length of delay did not correlate with pathologic tumour stage in this study.

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“…Resultado semelhante foi referido por outros autores, que não encontraram associação entre retardo no diagnóstico ou tratamento e estádio tumoral ou sobrevida dos pacientes. (10,12,15,29) Contrastando com esses dados, Christensen et al, (13) em um estudo dinamarquês incluindo 172 pacientes com câncer de pulmão, relataram ser o tempo entre o aparecimento dos sintomas e a cirurgia, e entre o primeiro contato com o sistema de saúde e a cirurgia menor nos pacientes com melhor prognóstico (estádios I e II). Em outro estudo, seis de 29 pacientes tornaram-se clinicamente incuráveis enquanto aguardavam radioterapia.…”

Section: Discussionunclassified

“…Diversos estudos avaliaram o tempo gasto para investigação e tratamento do câncer de pulmão e detectaram retardo excessivo, tanto relacionado ao paciente (5)(6)(7)(8)(9)(10)(11) quanto ao sistema de saúde no qual o paciente foi atendido. (12)(13)(14)(15)(16)(17) Segundo o Standing Medical Advisory Committee da Inglaterra, o tempo de investigação até a ressecção do tumor não deveria ultrapassar seis a oito semanas. (18) Entretanto, o impacto do tempo despendido até o início do tratamento do câncer de pulmão na sobrevida dos pacientes continua sendo discutido.…”

Section: Retardo No Diagnóstico E No Tratamento Cirúrgico Do Câncer Dunclassified

Retardo no diagnóstico e no tratamento cirúrgico do câncer de pulmão

Knorst¹,

Dienstmann²,

Fagundes³

2003

J. Pneumologia

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Introdução: O câncer de pulmão é a principal causa de morte relacionada a câncer no mundo.Objetivo: Determinar o tempo despendido com o diagnóstico, o estadiamento e o tratamento cirúrgico do cân-cer de pulmão em um hospital universitário.Método: Entre janeiro de 1990 e dezembro de 1998, 69 pacientes receberam diagnóstico de câncer de pulmão e foram tratados com cirurgia no Hospital das Clíni-cas de Porto Alegre. Os prontuários destes pacientes (53 homens e 16 mulheres) foram revisados, sendo coletados dados clínicos, histológicos, datas de consultas ambulatoriais, de internação hospitalar, de exames e de procedimentos, assim como o local de investigação.Resultados: Quinze pacientes foram investigados em ambulatório (grupo I), 28 em ambulatório e durante internação (grupo II) e 26 durante internação (grupo III). A idade dos pacientes variou entre 43 e 79 anos (média de 61 ± 10 anos). Quarenta e três pacientes eram tabagistas atuais e 23 ex-tabagistas. O tempo médio do aparecimento dos sintomas até a primeira consulta foi de 110 dias e da primeira consulta até o diagnóstico foi de 33 dias. Vinte e cinco dias transcorreram entre o diagnóstico e a cirurgia. A média de tempo da primeira consulta até a cirurgia (tempo total) foi de 58 dias. A média do tempo total foi de 72 dias no grupo I, 72 dias no grupo II e 35 dias no grupo III (p < 0,01). Não houve diferença significativa no tempo total, considerando-se os diferentes está-dios da doença (p = 0,16). Conclusões:Os resultados mostraram retardo na procura de atendimento médico e retardo adicional no tratamento do câncer de pulmão em pacientes cuja investigação foi ambulatorial. (J Pneumol 2003;29(6):358-64) Descritores -Neoplasias pulmonares/cirurgia. Avanços da doença.Background: Lung cancer is the leading cause of cancer-related death worldwide.Objective: To determine the time spent diagnosing, staging and surgically treating lung cancer in a university hospital. Method:Between January 1990 and December 1998, 69 (53 male, 16 female) patients were diagnosed with lung cancer and underwent surgery. The hospital records of these patients were reviewed to evaluate clinical and histological data, dates of outpatient visits, hospital admission, tests and procedures, as well as to determine if the patients were examined as inpatients or as outpatients. Results:The 15 patients investigated as outpatients were designated as group I, the 28 examined as both inpatients and outpatients as group II, and the 26 investigated as inpatients as group III. Age ranged from 43 to 79 years (mean ± SD; 61 ± 10). Of the 69 patients, 43 were smokers and 23 were ex-smokers. The mean time from onset of symptoms to the first outpatient visit was 110 days and 33 days from the first outpatient visit until diagnosis. There was a lapse of 25 days between diagnosis and surgery. The mean total elapsed time between the first outpatient visit and surgery was 58 days. The mean total time was 72 days for group I, 72 days for group II, and 35 days for group III (p < 0.01). There was no significant di...

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The impact of delayed diagnosis of lung cancer on the stage at the time of operation

Abstract: A few months delay before final treatment of a non-small-cell lung cancer seems to have an impact on the perioperative stage of the cancer, and thereby on the patients prognosis. A screening of asymptomatic risk-group patients will result in recognition of early lung cancer.

Cited by 97 publications

References 12 publications

Impact of Delay on Diagnosis and Treatment of Primary Lung Cancer

Impact of Delay on Diagnosis and Treatment of Primary Lung Cancer

Delays in the Diagnosis and Treatment of Primary Lung Cancer: Are Longer Delays Associated with Advanced Pathological Stage?

Retardo no diagnóstico e no tratamento cirúrgico do câncer de pulmão

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