title: Is it safe to wait? The effect of surgical wait time on survival in patients with non-small cell lung cancer.
abstract: BACKGROUND
  The effect of surgical wait times on survival in patients with non-small cell lung cancer (NSCLC) remains largely unknown. Our objective was to determine the effect of surgical wait time on survival and incidence of upstaging in patients with stage I and II NSCLC.
  
  
  METHODS
  All patients with clinical stage I and II NSCLC who underwent surgical resection in a single centre between January 2010 and December 2011 were reviewed. Analysis was stratified based on preoperative clinical stage. We assessed the effect of wait time on survival using a Cox proportional hazard model with wait time in months as a categorical variable. Incidence of upstaging at least 1 stage was assessed using logistic regression.
  
  
  RESULTS
  We identified 222 patients: 180 were stage I and 42 were stage II. For stage I, wait times up to 4 months had no significant effect on survival or incidence of upstaging. For stage II, patients waiting between 2 and 3 months had significantly decreased survival (hazard ratio 3.6, p = 0.036) and increased incidence of upstaging (odds ratio 2.0, p = 0.020) than those waiting 0 to 1 month. For those waiting between 1 and 2 months, there was no significant difference in survival or upstaging.
  
  
  CONCLUSIONS
  We did not identify an effect of wait time up to 4 months on survival or upstaging for patients with stage I NSCLC. For patients with stage II disease, wait times greater than 2 months adversely affected survival and upstaging.
authors.affiliation: From the London Health Sciences Centre, London, Ont. (Coughlin, Guidolin, Frechette, Malthaner, Inculet); and the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS (Plourde).
authors.forename: Shaun
authors.initials: S
authors.lastname: Coughlin
authors.affiliation: From the London Health Sciences Centre, London, Ont. (Coughlin, Guidolin, Frechette, Malthaner, Inculet); and the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS (Plourde).
authors.forename: Madelaine
authors.initials: M
authors.lastname: Plourde
authors.affiliation: From the London Health Sciences Centre, London, Ont. (Coughlin, Guidolin, Frechette, Malthaner, Inculet); and the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS (Plourde).
authors.forename: Keegan
authors.initials: K
authors.lastname: Guidolin
authors.affiliation: From the London Health Sciences Centre, London, Ont. (Coughlin, Guidolin, Frechette, Malthaner, Inculet); and the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS (Plourde).
authors.forename: Dalilah
authors.initials: D
authors.lastname: Fortin
authors.affiliation: From the London Health Sciences Centre, London, Ont. (Coughlin, Guidolin, Frechette, Malthaner, Inculet); and the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS (Plourde).
authors.forename: Eric
authors.initials: E
authors.lastname: Frechette
authors.affiliation: From the London Health Sciences Centre, London, Ont. (Coughlin, Guidolin, Frechette, Malthaner, Inculet); and the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS (Plourde).
authors.forename: Richard
authors.initials: R
authors.lastname: Malthaner
authors.affiliation: From the London Health Sciences Centre, London, Ont. (Coughlin, Guidolin, Frechette, Malthaner, Inculet); and the Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS (Plourde).
authors.forename: Richard
authors.initials: R
authors.lastname: Inculet
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009864:Ontario / Q000453:epidemiology; D061646:Operative Time; D011013:Pneumonectomy / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors