Timeliness to treatment in patients with lung cancer at UVA Cancer Center.

169 Background: The current standard of care for lung cancer patients recommends initiation of treatment within 30 days of diagnosis; however, the effects of delayed treatment on prognosis have not been determined. Furthermore, it is unclear what factors lead to delayed care. Longer treatment delays have been associated with decreased survival outcomes in other cancers, but such associations have not been established for lung cancer. This study analyzed lung cancer patients at UVa Cancer Center to identify the factors associated with delayed treatment and the effect of this delay on overall survival outcomes. Methods: Lung cancer patients diagnosed from 2011 to 2014 were retrospectively analyzed using UVA Cancer Registry data. Two outcomes, diagnosis to treatment time interval, and overall survival were modeled. Multivariate analysis was used to identify the variables that affected timely care. Statistical tests were used to determine whether there were significant differences in overall survival between patients who received timely and delayed care. Results: 917 patients met the criteria for analysis. Most were stage I (47.5%) and received surgery as first line of treatment (57.7%). Median age was 66 years. The median treatment interval for this cohort was 32 days. Stage at diagnosis was major determinant for time to treatment (p = 0.0197), with stage IV patients being treated in shorter intervals (median 28 days) and stage III patients the longest (34 days). Treatment delay was not associated with overall survival (p-value 0.952) however, other covariates such as insurance type, primary treatment type and stage were (p-values < 0.0001, < 0.0001, < 0.0001). Conclusions: Complex multidisciplinary care can lead to delays in treatment. Stage and type of primary treatment type were determinants of treatment delays and should be recognized as obstacles to timely treatment. Although delays were not associated with survival in our study, further investigation to determine the impact of delays on symptoms, quality of life, and performance status is warranted.