Effect of symptom-to-treatment interval on prognosis in lung cancer.
OBJECTIVE
To evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer.


METHODS
One hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification.


RESULTS
The patients were followed up for a mean period (= SD) of 7.4+/-8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120+/-101 days (median, 90). The mean length of the symptom-to-doctor interval was 63+/-62 days (median, 45), while the doctor-to-diagnosis and diagnosis-to-treatment intervals were 41 +/-82 days (median, 10) and 16+/-12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC.


CONCLUSIONS
The shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.
Annakkaya
All Nihat
AN
Department of Chest Diseases, Faculty of Medicine, Abant Izzet Baysal University, Duzce, Turkey. annakkaya@gmail.com
Arbak
Peri
P
Balbay
Oner
O
Bilgin
Cahit
C
Erbas
Mete
M
Bulut
Ismet
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors