title: Chronic obstructive pulmonary disease and vascular disease delay timeliness of early stage lung cancer resectional surgery.
abstract: BACKGROUND
  Lung cancer remains the leading cause of cancer death in the United States and worldwide. Timeliness to diagnosis and referral for resectional surgery is key to successful management for early stage disease.
  
  
  METHODS
  We investigated the contribution of medical co-morbidities in the timeliness to resectional surgery for non-small cell lung cancer (NSCLC). A retrospective record review of NSCLC surgery cases at Naval Medical Center San Diego (NMCSD) from 2004 to 2009 from the tumor registry was conducted.
  
  
  RESULTS
  More than 75% of NSCLC patients exhibited at least one co-morbidity. Of the 84 patients, 26% of patients had diabetes, patients with different vascular co-morbidities accounted for 39%, whereas 33% of subjects had COPD. Patients with sleep apnea or liver disease each accounted for 6%. Vascular disease co-morbidity and COPD in NSCLC patients significantly delayed time from initial cardiothoracic surgery evaluation to thoracotomy (p = 0.01-0.02 and p < 0.05 respectively).
  
  
  CONCLUSIONS
  Although significances of different co-morbities in the development NSCLC cannot be extrapolated, theses data show that COPD and vascular diseases are significant risk factors that delay surgical treatment of early stage lung cancer.
authors.affiliation: Department of Pulmonary Medicine, Naval Medical Center San Diego, San Diego, CA 92134, USA. gilbert.seda@gmail.com
authors.forename: Gilbert
authors.initials: G
authors.lastname: Seda
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Stafford
authors.forename: John S
authors.initials: JS
authors.lastname: Parrish
authors.forename: Steven P
authors.initials: SP
authors.lastname: Praske
authors.forename: Massoud
authors.initials: M
authors.lastname: Daheshia
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D013908:Thoracotomy; D013997:Time Factors; D014652:Vascular Diseases / Q000150:complications*