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  EP1.05 - Interventional Diagnostics/Pulmonology (ID 195)

  • Event: WCLC 2019
  • Type: E-Poster Viewing in the Exhibit Hall
  • Track: Interventional Diagnostics/Pulmonology
  • Presentations: 1
  • Now Available
  • Moderators:
  • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall

  • 31990

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    EP1.05-07 - Examining Endobronchial Ultrasound (EBUS) Utilisation in Lung Cancer Diagnosis and Treatment Delay. A Restrospective Observational Study (Now Available) (ID 2933)

    08:00 - 18:00  |  Author(s): Eli Dabscheck
    • Abstract
    • Slides

    Background
    

    Introduction

    • EBUS has high diagnostic yield in the assessment of mediastinal lymphadenopathy, staging and diagnosis of lung cancer. (1)

    • FDG PET/CT scans can be used in the initial assessment of hilar and mediastinal nodes, EBUS-TBNA has a higher sensitivity and specificity for staging these lymph nodes in patients with lung cancer. (2)

    • The provision of high quality EBUS demands that procedures are delivered in a manner which is demonstrably evidence based, effective, equitable, safe, patient-centred and timely.

    • Timeliness in EBUS provision will ensure a minimum in patient related anxiety and minimal prolongation of the referral to diagnosis and referral to treatment intervals.

    Objective

    To examine the impact of EBUS wait time on diagnosis and treatment delay in evaluating lung cancer and mediastinal lymphadenopathy within the Alfred Hospital.

    Method
    

    Method

    A retrospective chart review of diagnosed lung cancer patients undergoing EBUS (linear and radial) at the Alfred Hospital between August 2013 and September 2018 was conducted. We recorded the waiting interval between EBUS referral and procedure and examined impact on lung cancer management timeliness from lung cancer referral to lung cancer diagnosis and first treatment based on electronic records. Electronic records were also used to gather baseline patient characteristics.

    Result
    

    103 EBUS procedures were completed on 96 patients with the below characteristics.

    Lung cancer referral to diagnosis interval had mean 23.2 days (30.5 SD), diagnosis to treatment interval had mean 24.1 days (21.2 SD), and referral to treatment interval had mean 47.4 days (35.9 SD).

    EBUS within one week of EBUS referral, n(%)	70 (79%)
    EBUS within two weeks of EBUS referral, n(%)	85 (96%)

    EBUS waiting time was compared for lung cancer referral to diagnosis interval (within vs delay of greater than 28 days), and diagnosis to treatment interval (within vs delay of more than 14 days). There was a trend towards diagnosis delay with prolonged wait for EBUS (p=0.052). Significantly, EBUS wait time was greater for delayed referral to treatment interval (more than 42 days), than within 42 days (p=0.012).

    Conclusion
    

    Delay in investigation has the potential to delay key management issues including lung cancer diagnosis and treatment. Prolonged wait for EBUS lead to a trend towards diagnosis delay and significant delay in referral to treatment interval in this cohort. Further assessment of causes in EBUS delay warrants further investigation.

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