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简短报告:针对疑似肺癌的多学科初步检查作为通向组织病理学诊断的快速通道干预措施

Brief Report: A Multidisciplinary Initial Workup for Suspected Lung Cancer as Fast-Track Intervention to Histopathologic Diagnosis.

作者信息

Pujol Jean-Louis, Mercier Grégoire, Vasile Maria, Serre Isabelle, Vernhet-Kovacsik Hélène, Bommart Sébastien

机构信息

Thoracic Oncology Unit, University Hospital of Montpellier, Montpellier, France.

Cancerology Resarch Institute of Montpellier (IRCM), National Institute for Health and Medical Research (INSERM) Unit-U1194, Montpellier, France.

出版信息

JTO Clin Res Rep. 2023 May 12;4(6):100526. doi: 10.1016/j.jtocrr.2023.100526. eCollection 2023 Jun.

Abstract

Guidelines for optimal timing of lung cancer diagnosis and treatment have been implemented in many countries, but the effect of fast-track interventions on the shortening of time interval is still debatable. In this study, the delay from the first specialist visit to the histopathologic diagnosis was compared between two patient cohorts: before (n = 280) and after (n = 247) implementation of a fast-track multidisciplinary diagnosis program. The cumulative incidence function curves were compared, and hazard ratio was adjusted in the Cox model. The implementation allowed a statistically significant increase in the cumulative incidence of the lung cancer histopathologic diagnosis over time. Adjusted hazard ratio for patients accrued in the post-implementation cohort was 1.22 (1.03-1.45) ( = 0.023), corresponding to a reduction of this waiting period by 18%. In conclusion, a multidisciplinary approach of the diagnostic process implemented at the initial visit allows a significant reduction of the timeline until the histopathologic diagnosis of lung cancer.

摘要

许多国家已实施肺癌诊断和治疗的最佳时机指南,但快速干预措施对缩短时间间隔的效果仍存在争议。在本研究中,比较了两个患者队列从首次专科就诊到组织病理学诊断的延迟时间:实施快速多学科诊断计划之前(n = 280)和之后(n = 247)。比较了累积发病率函数曲线,并在Cox模型中调整了风险比。实施该计划后,随着时间的推移,肺癌组织病理学诊断的累积发病率有统计学意义的增加。实施后队列中患者的调整后风险比为1.22(1.03 - 1.45)(P = 0.023),相当于将等待期缩短了18%。总之,在初次就诊时实施多学科诊断方法可显著缩短直至肺癌组织病理学诊断的时间线。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3829/10275718/b3afdb805f0e/gr1.jpg

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