Does treatment delay affect survival in non-small cell lung cancer? A retrospective analysis from a single UK centre

We analysed survival in relation both to time to treatment and other clinic al parameters in the care pathway of non-small cell lung cancer (NSCLC) pat ients. Medical notes of 189 patients diagnosed with NSCLC presenting in 199 8 were reviewed. Median time to treatment in all patients was 48 days. In m ultivariate analysis, time to treatment did not affect survival in patients with any stage of disease. Referral from general practitioner to chest dep artment (P=0.032, HR=0.08), and absence of use of surgery (P=0.006, HR=30.3 0) were independently significant predictors of survival in stages I and 2 subgroup. In stage 3 patients, absence of laboratory abnormality (P=0.002, HR=0.39), and use of combined treatment (P=0.015, HR=0.17) were independent prognosticators. Lastly, in patients with stage 4 disease, presence of bon e and/or liver metastasis (P=0.005, HR=2.65), and absence of use of chemoth erapy (P < 0.001, HR=6.25) were significantly associated with shorter survi val. As survival is dependent on classical prognosticators, but not on time from referral to treatment (hospital delay), expanding resources in oncolo gy (equipment, drugs and personnel), and, perhaps, reducing patient delay, rather than reducing hospital delay alone, could be better strategies to im prove NSCLC survival. (C) 2001 Elsevier Science Ireland Ltd. All rights res erved.