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Using a Dedicated Interventional Pulmonology Practice Decreases Wait Time Before Treatment Initiation for New Lung Cancer Diagnoses

  • LUNG CANCER
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Abstract

Purpose

While there is significant mortality and morbidity with lung cancer, early stage diagnoses carry a better prognosis. As lung cancer screening programs increase with more pulmonary nodules detected, expediting definitive treatment initiation for newly diagnosed patients is imperative. The objective of our analysis was to determine if the use of a dedicated interventional pulmonology practice decreases time delay from new diagnosis of lung cancer or metastatic disease to the chest to treatment initiation.

Methods

Retrospective chart analysis was done of 87 consecutive patients with a new diagnosis of primary lung cancer or metastatic cancer to the chest from our interventional pulmonology procedures. Demographic information and time intervals from abnormal imaging to procedure and to treatment initiation were recorded.

Results

Patients were older (mean age 69) and former or current smokers (72%). A median of 27 days (1–127 days) passed from our diagnostic biopsy to treatment initiation. A median of 53 total days (2–449 days) passed from abnormal imaging to definitive treatment. Endobronchial ultrasound-guided transbronchial needle aspiration was the most commonly used diagnostic procedure (59%), with non-small cell lung cancer the majority diagnosis (64%). For surgical patients, all biopsy-negative lymph nodes from our procedures were cancer-free at surgical excision.

Conclusions

Compared to prior reports from international and United States cohorts, obtaining a tissue biopsy diagnosis through a gatekeeper interventional pulmonology practice decreases median delay from abnormal imaging to treatment initiation. This finding has the potential to positively impact patient outcomes and requires further evaluation.

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Abbreviations

Cryo:

Flexible cryoprobe biopsy and tissue extraction

EBUS-TBNA:

Endobronchial ultrasound-guided biopsy transbronchial needle aspiration

ECH:

El Camino Hospital

EMN:

Electromagnetic navigation-guided biopsy

IP:

Interventional pulmonology

NSCLC:

Non-small cell lung cancer

PAMF:

Palo Alto Medical Foundation

SHN:

Sutter Health Network

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Acknowledgements

The authors would like to thank Dominick L. Frosch, PhD for assistance with statistical analysis.

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Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, University of California, Los Angeles, 10833 LeConte Avenue, Los Angeles, CA, 90095, USA

    Bryan S. Benn

  2. Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Mihir Parikh

  3. Division of Thoracic Surgery, Palo Alto Medical Foundation, Palo Alto, CA, USA

    Pei H. Tsau

  4. Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CA, USA

    Eric Seeley & Ganesh Krishna

  5. Division of Pulmonary and Critical Care Medicine, Palo Alto Medical Foundation, Palo Alto, CA, USA

    Ganesh Krishna

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Correspondence to Bryan S. Benn.

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Benn, B.S., Parikh, M., Tsau, P.H. et al. Using a Dedicated Interventional Pulmonology Practice Decreases Wait Time Before Treatment Initiation for New Lung Cancer Diagnoses. Lung 197, 249–255 (2019). https://doi.org/10.1007/s00408-019-00207-6

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  • DOI: https://doi.org/10.1007/s00408-019-00207-6

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