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Carole Saint-Pierre



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    P1.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 947)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.15-13 - Wait Times for Diagnosis and Treatment of Lung Cancer Across the Province of Quebec, Canada (ID 13472)

      16:45 - 18:00  |  Author(s): Carole Saint-Pierre

      • Abstract
      • Slides

      Background

      Multiple clinical practice guidelines recommend rapid evaluation of patients with suspected lung cancer. Diagnostic pathways and wait times vary considerably from one centre to another.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We retrospectively reviewed medical records of all patients (n=1217) across the province of Quebec who had a biopsy-proven diagnosis of lung cancer between February 1st and April 30th, 2017. Median wait times for diagnosis and treatment were calculated.

      4c3880bb027f159e801041b1021e88e8 Result

      Patient characteristics are shown in Table 1. Median wait times for investigation and treatment are shown in Table 2. There were variations between centres and regions.

      Characteristic

      No (%)

      Age, years, mean (range)

      68.5 (20-94)

      Male sex

      585 (48)

      Smoking status

      Former or current smoker

      Never smoker

      Unknown

      1120 (92)

      60 (5)

      37 (3)

      ECOG performance status

      0

      1

      ≥2

      Missing

      416 (34)

      358 (30)

      393 (32)

      50 (4)

      Histology

      Adenocarcinoma

      631 (52)

      Squamous cell carcinoma

      284 (23)

      NSCLC NOS

      70 (6)

      SCLC

      178 (15)

      Other

      54 (4)

      TNM stage

      I

      213 (18)

      II

      114 (9)

      III

      227 (19)

      IV

      475 (39)

      Limited SCLC

      40 (3)

      Extensive SCLC

      138 (11)

      Missing

      10 (1)

      Known positive EGFR mutation status (n=395 tested)

      Known positive ALK translocation status (n=387 tested)

      PD-L1 TPS (n=386 tested)

      <1%

      1-49%

      ≥50%

      Number of investigations per patient, median (IQR)

      28 (7)

      6 (2)

      85 (22)

      151 (39)

      150 (39)

      7 (6, 8)

      Tumor board review

      194 (16)

      Final diagnostic procedure

      Flexible bronchoscopy

      338 (28)

      EBUS/EUS

      223 (18)

      Transthoracic needle biopsy

      301 (25)

      Thoracoscopy

      139 (11)

      Biopsy of metastatic site

      145 (12)

      Sputum cytology

      1 (0)

      Thoracentesis

      61 (5)

      Mediastinoscopy

      Missing

      2 (0)

      7 (1)

      ECOG = Eastern Cooperative Oncology Group; NSCLC = non-small cell lung cancer; NOS = not otherwise specified; SCLC = small cell lung cancer; EGFR = epidermal growth factor receptor; ALK = anaplastic lymphoma kinase; TPS = tumor proportion score; IQR = interquartile range; EBUS = endobronchial ultrasonography; EUS = endoscopic ultrasonography.

      Table 2 – Median wait times for investigation and treatment

      Investigation or treatment interval

      Pts (n)

      Median wait, days (IQR)

      Referral to first appointment with specialist

      972

      2 (0, 7)

      First appointment to diagnosis

      1152

      18 (8, 43)

      Diagnosis to first treatment

      930

      22 (5, 42)

      Referral to first treatment

      737

      58 (28, 89)

      Abnormal imaging to first treatment

      902

      72 (39, 111)

      Surgery

      268

      109 (80, 142)

      Radiation

      362

      59 (28, 98)

      Systemic therapy

      330

      62 (35, 92)

      8eea62084ca7e541d918e823422bd82e Conclusion

      To our knowledge, this is the largest multicentre review of wait times for diagnosis and treatment of lung cancer with detailed characteristics of patients. Data will be completed and updated prior to the meeting, to try to identify specific factors associated with longer wait times.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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