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Vol. 43. Issue 3.
Pages 165-170 (January 2007)
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Vol. 43. Issue 3.
Pages 165-170 (January 2007)
Original Articles
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Influence of Delay of Surgery on the Survival of Patients With Bronchogenic Carcinom
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Miguel Ángel Cañizares Carreteroa,
Corresponding author
macaniz@telefonica.net

Correspondence: Dr. M.A. Cañizares Carretero. Servicio de Cirugía Torácica. Complexo Hospitalario Universitario de Vigo (Hospital Xeral). Pizarro, 22. 36204 Vigo. Pontevedra. España
, José Eduardo Rivo Vázqueza, Montserrat Blanco Ramosa, Alberto Toscano Novellaa, Eva María García Fontána, María Jesús Purriños Hermidab
a Servicio de Cirugía Torácica, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
b Unidad de Investigación Clinicoepidemiológica, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
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Objective

Bronchogenic carcinoma is the main cause of tumor-related deaths among men in Spain. The British Thoracic Society recommends that no longer than 4 weeks should pass from the moment a patient's name is placed on a waiting list until surgery takes place. We analyzed the influence of time until surgery on survival in patients with lung cancer.

Patients and Methods

We operated on 108 patients diagnosed with bronchogenic carcinoma between January 1, 2001 and December 31, 2002. The time until surgery was defined by the date of application for care in our department until the moment of surgery.

Results

The mean time on the waiting list was 56.87 days. No significant differences in mean wait-list times could be found in relation to tumor stage, type of surgery, patient age, or complete resection rate. The median survival in this patient series was 35 months. No significant differences in survival were found in relation to time until surgery in either the univariate or multivariate analysis. Pathologic stage, complete resection of the tumor, and patient age were prognostic factors.

Conclusions

We found no evidence that delaying surgery affects survival in lung cancer patients. However, efforts should be made to reduce surgical wait-list times to bring them into line with the recommendations of scientific societies.

Key words:
Bronchogenic carcinoma
Waiting lists: surgery
Tumor resection
Objetivo

La primera causa de muerte de origen neoplásico en varones en nuestro medio es el carcinoma broncogénico. La British Thoracic Society recomienda que el tiempo de demora quirúrgica desde el momento de inclusión en una lista de espera hasta la cirugía ha de ser menor de 4 semanas. Analizamos la influencia de la espera quirúrgica en la supervivencia de estos pacientes.

Pacientes y Métodos

Entre el 1 de enero de 2001 y el 31 de diciembre de 2002 se intervino en nuestro servicio a 108 pacientes con el diagnóstico de carcinoma broncogénico. El tiempo de espera quirúrgica se consideró desde la fecha de solicitud de asistencia en nuestro servicio hasta el momento de la cirugía.

Resultados

La media de los tiempos de espera fue de 56,87 días. No se hallaron diferencias significativas en las medias de los tiempos de espera según el estadio tumoral, el tipo de cirugía practicada, la edad del paciente o el índice de resección completa. La mediana de supervivencia de la serie fue de 35 meses. No se apreciaron diferencias significativas en la supervivencia en relación con la demora quirúrgica en el estudio univariante ni en el multivariante. El estadio patológico, la resección completa del tumor y la edad del paciente demostraron ser factores pronósticos.

Conclusiones

No hemos encontrado evidencia de que nuestra demora quirúrgica influya en la supervivencia de estos pacientes. No obstante, nuestros esfuerzos deben dirigirse a la reducción de estos tiempos de espera quirúrgica hasta que se aproximen a las recomendaciones de las sociedades científicas.

Palabras clave:
Carcinoma broncogénico
Demora quirúrgica
Resección tumoral
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REFERENCES
[1]
SH Landis, T Murray, S Bolden, PA Wingo.
Cancer statistics, 1999.
CA Cancer J Clin, 49 (1999), pp. 8-31
[2]
C Montero, M Rosales, I Otero, M Blanco, G Rodríguez, S Peterga, et al.
Cáncer de pulmón en el área sanitaria de A Coruña: incidencia, abordaje clínico y supervivencia.
Arch Bronconeumol, 39 (2003), pp. 209-216
[3]
The Lung Cancer Working Party of the British Thoracic Society Standards of Care Committee.
BTS recommendations to respiratory physicians for organising the care of patients with lung cancer.
Thorax, 53 (1998), pp. 1-8
[4]
FG Aragoneses, N Moreno, P León, E García-Fontán, E Folqué, Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S).
Influence of delays on survival in the surgical treatment of bronchogenic carcinoma.
Lung Cancer, 36 (2002), pp. 59-63
[5]
A López Encuentra, JL Martín de Nicolás, M Casado López, E De Miguel Poch, C Marrón Fernández.
Demoras en el diagnóstico y en el tratamiento quirúrgico del carcinoma broncogénico.
Arch Bronconeumol, 34 (1998), pp. 123-126
[6]
JS Billing, FC Wells.
Delays in the diagnosis and surgical treatment of lung cancer.
Thorax, 51 (1996), pp. 903-906
[7]
J Lee, A Marchbank, P Goldstraw.
Implementation of the British Thoracic Society recommendations for organising the care of patients with lung cancer: the surgeon's perspective.
Ann R Coll Surg Engl, 84 (2002), pp. 304-308
[8]
M Liberman, D Liberman, JS Sampalis, DS Mulder.
Delays to surgery in non-small-cell lung cancer.
Can J Surg, 49 (2006), pp. 31-36
[9]
ED Christensen, T Harvald, M Jendresen, S Aggestrup, G Petterson.
The impact of delayed diagnosis of lung cancer on the stage at the time of operation.
Eur J Cardiothorac Surg, 12 (1997), pp. 880-884
[10]
JL Duque, G Ramos, J Castrodeza, J Cerezal, M Castanedo, MG Yuste, et al.
Early complications in surgical treatment of lung cancer: a prospective, multicenter study. Grupo Cooperativo de Carcinoma Broncogénico de la Sociedad Española de Neumología y Cirugía Torácica.
Ann Thorac Surg, 63 (1997), pp. 944-950
[11]
M de Perrot, M Licker, MA Reymond, J Robert, A Spiliopoulos.
Influence of age on operative mortality and long-term survival after lung resection for bronchogenic carcinoma.
Eur Respir J, 14 (1999), pp. 419-422
[12]
A Page, G Nakhle, C Mercier, A Verdant, P Page, L Dontigny, et al.
Surgical treatment of bronchogenic carcinoma: the importance of staging in evaluating late survival.
Can J Surg, 30 (1987), pp. 96-99
[13]
DAR Boldy, WS Lim, FD Salama.
Delays in the diagnosis and surgical treatment of lung cancer.
Thorax, 52 (1997), pp. 837
[14]
RL Quaterman, A McMillan, MB Ratcliffe, MI Block.
Effect of preoperative delay on prognosis for patients with early stage nonsmall cell lung cancer.
J Thorac Cardiovasc Surg, 125 (2003), pp. 25-26
[15]
G Myrdal, M Lambe, G Hillerdal, K Lamberg, T Agustsson, E Stahle.
Effect of delays on prognosis in patients with non-small cell lung cancer.
Thorax, 59 (2004), pp. 45-49
[16]
H Bozcuk, C Martin.
Does treatment delay affect survival in nonsmall cell lung cancer? A retrospective analysis from a single UK center.
Lung cancer, 34 (2001), pp. 243-252
[17]
T Naruke, R Tsuchiya, H Kondo, H Asamura.
Prognosis and survival after resection for bronchogenic carcinoma based on the 1997 TNM-staging classification: the Japanese experience.
Ann Thorac Surg, 71 (2001), pp. 1759-1764
[18]
WM Alberts, G Bepler, T Hazelton, JC Ruckdeschel, JH Williams, American College of Chest Physicians.
Lung cancer. Practice organization.
Chest, 123 (2003), pp. 332S-337S
[19]
KA Kern.
Medicolegal analysis of the delayed diagnosis of cancer in 338 cases in the United States.
Arch Surg, 129 (1994), pp. 397-403
[20]
E Simo Cruzet, MM Ureña Tapia, M Vernet Vernet, MJ Sender Palacios, P Larrossa Saez, E Jovell Fernández.
Intervención del médico de familia en el diagnóstico de cáncer.
Aten Primaria, 26 (2000), pp. 104-106
[21]
AR Jensen, J Mainz, J Overgaard.
Impact of delay on diagnosis and treatment of primary lung cancer.
Acta Oncol, 41 (2002), pp. 147-152
[22]
JM González, FJ de Castro, M Barrueco, R Cordovilla, JL Fernández, FP Gómez.
Demoras diagnósticas en el cáncer de pulmón.
Arch Bronconeumol, 39 (2003), pp. 437-441
[23]
A Moody, M Muers, D Forman.
Delays in managing lung cancer.
Thorax, 59 (2004), pp. 1-3
[24]
C Laroche, F Wells, R Coluden, S Stewart, M Goddard, E Lowry, et al.
Improving surgical resection rate in lung cancer.
Thorax, 53 (1998), pp. 445-449
Copyright © 2007. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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