Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals

Sylvia Genet; Esther Visser; Maggy Youssef-El Soud; Huub N.A. Belderbos; Gerben Stege; Marleen E.A. de Saegher; Susan C. van 't Westeinde; Luc Brunsveld; Maarten A.C. Broeren; Daan van de Kerkhof; Federica Eduati; Ben E.E.M. van den Borne; Volkher Scharnhorst

doi:10.1016/j.lungcan.2024.107477

Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals

Sylvia Genet, Esther Visser, Maggy Youssef-El Soud, Huub N.A. Belderbos, Gerben Stege, Marleen E.A. de Saegher, Susan C. van 't Westeinde, Luc Brunsveld, Maarten A.C. Broeren, Daan van de Kerkhof, Federica Eduati, Ben E.E.M. van den Borne, Volkher Scharnhorst (Corresponding author)

Onderzoeksoutput: Bijdrage aan tijdschrift › Tijdschriftartikel › Academic › peer review

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OBJECTIVES: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, adherence with existing Dutch guidelines for timeliness and type and number of invasive and imaging procedures was assessed.

MATERIALS AND METHODS: 1096 patients with suspected LC were enrolled in this multicenter prospective study (NL9146). The overall survival, time from referral to the first appointment with the pulmonologist, time to diagnosis and treatment, and the number of imaging and invasive procedures were evaluated. Patients were divided into different diagnostic groupsearly- and advanced stage non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC), patients without LC and patients without a definitive diagnosis.

RESULTS: The majority of patients (66 %) received a definitive diagnosis within 5 weeks, although the time to diagnosis of early-stage LC patients and patients without LC was significantly longer comparted to advanced stage LC. An increase in invasive procedures was seen for early-stage LC compared to advanced stage LC and for 13 % of the advanced stage non-squamous NSCLC patients up to three additional invasive procedures were performed solely to obtain sufficient material for NGS. For patients without a definitive diagnosis, 50 % did undergo at least one invasive procedure, while 11 % did not wish to undergo any invasive procedures.

CONCLUSION: These insights could aid in improved LC diagnostics and efficient implementation of new techniques like liquid biopsy and artificial intelligence. This may lead to more timely LC care, a decreased number of invasive procedures, less variability between the diagnostic trajectory of different patients and aid in obtaining a definitive diagnosis for all patients.

Originele taal-2	Engels
Artikelnummer	107477
Aantal pagina's	8
Tijdschrift	Lung Cancer
Volume	189
Vroegere onlinedatum	22 jan. 2024
DOI's	https://doi.org/10.1016/j.lungcan.2024.107477
Status	Gepubliceerd - mrt. 2024

Financiering

The study was supported by The Netherlands Organization for Scientific Research (NWO) via LIFT grant 731.017.405. Supported by AstraZeneca grant AZNL201700295 and Catharina Onderzoeksfonds institutional fund grant 2017-02 (R.d.K.). We would like to acknowledge Remco de Kock (R.d.K) for his work in patient inclusion and data collection.

Financiers	Financiernummer
AstraZeneca	AZNL201700295, 2017-02
Nederlandse Organisatie voor Wetenschappelijk Onderzoek	731.017.405

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Genet, S., Visser, E., Youssef-El Soud, M., Belderbos, H. N. A., Stege, G., de Saegher, M. E. A., van 't Westeinde, S. C., Brunsveld, L., Broeren, M. A. C., van de Kerkhof, D., Eduati, F., van den Borne, B. E. E. M., & Scharnhorst, V. (2024). Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals. Lung Cancer, 189, Artikel 107477. https://doi.org/10.1016/j.lungcan.2024.107477

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title = "Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals",

abstract = "OBJECTIVES: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, adherence with existing Dutch guidelines for timeliness and type and number of invasive and imaging procedures was assessed.MATERIALS AND METHODS: 1096 patients with suspected LC were enrolled in this multicenter prospective study (NL9146). The overall survival, time from referral to the first appointment with the pulmonologist, time to diagnosis and treatment, and the number of imaging and invasive procedures were evaluated. Patients were divided into different diagnostic groupsearly- and advanced stage non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC), patients without LC and patients without a definitive diagnosis.RESULTS: The majority of patients (66 %) received a definitive diagnosis within 5 weeks, although the time to diagnosis of early-stage LC patients and patients without LC was significantly longer comparted to advanced stage LC. An increase in invasive procedures was seen for early-stage LC compared to advanced stage LC and for 13 % of the advanced stage non-squamous NSCLC patients up to three additional invasive procedures were performed solely to obtain sufficient material for NGS. For patients without a definitive diagnosis, 50 % did undergo at least one invasive procedure, while 11 % did not wish to undergo any invasive procedures.CONCLUSION: These insights could aid in improved LC diagnostics and efficient implementation of new techniques like liquid biopsy and artificial intelligence. This may lead to more timely LC care, a decreased number of invasive procedures, less variability between the diagnostic trajectory of different patients and aid in obtaining a definitive diagnosis for all patients.",

keywords = "Diagnostic procedures, Lung cancer care, Survival, Timeliness",

author = "Sylvia Genet and Esther Visser and {Youssef-El Soud}, Maggy and Belderbos, {Huub N.A.} and Gerben Stege and {de Saegher}, {Marleen E.A.} and {van 't Westeinde}, {Susan C.} and Luc Brunsveld and Broeren, {Maarten A.C.} and {van de Kerkhof}, Daan and Federica Eduati and {van den Borne}, {Ben E.E.M.} and Volkher Scharnhorst",

year = "2024",

month = mar,

doi = "10.1016/j.lungcan.2024.107477",

language = "English",

volume = "189",

journal = "Lung Cancer",

issn = "0169-5002",

publisher = "Elsevier Ireland Ltd",

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Genet, S, Visser, E, Youssef-El Soud, M, Belderbos, HNA, Stege, G, de Saegher, MEA, van 't Westeinde, SC, Brunsveld, L , Broeren, MAC , van de Kerkhof, D , Eduati, F, van den Borne, BEEM & Scharnhorst, V 2024, 'Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals', Lung Cancer, vol. 189, 107477. https://doi.org/10.1016/j.lungcan.2024.107477

TY - JOUR

T1 - Strengths and challenges in current lung cancer care

T2 - Timeliness and diagnostic procedures in six Dutch hospitals

AU - Genet, Sylvia

AU - Visser, Esther

AU - Youssef-El Soud, Maggy

AU - Belderbos, Huub N.A.

AU - Stege, Gerben

AU - de Saegher, Marleen E.A.

AU - van 't Westeinde, Susan C.

AU - Brunsveld, Luc

AU - Broeren, Maarten A.C.

AU - van de Kerkhof, Daan

AU - Eduati, Federica

AU - van den Borne, Ben E.E.M.

AU - Scharnhorst, Volkher

PY - 2024/3

Y1 - 2024/3

N2 - OBJECTIVES: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, adherence with existing Dutch guidelines for timeliness and type and number of invasive and imaging procedures was assessed.MATERIALS AND METHODS: 1096 patients with suspected LC were enrolled in this multicenter prospective study (NL9146). The overall survival, time from referral to the first appointment with the pulmonologist, time to diagnosis and treatment, and the number of imaging and invasive procedures were evaluated. Patients were divided into different diagnostic groupsearly- and advanced stage non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC), patients without LC and patients without a definitive diagnosis.RESULTS: The majority of patients (66 %) received a definitive diagnosis within 5 weeks, although the time to diagnosis of early-stage LC patients and patients without LC was significantly longer comparted to advanced stage LC. An increase in invasive procedures was seen for early-stage LC compared to advanced stage LC and for 13 % of the advanced stage non-squamous NSCLC patients up to three additional invasive procedures were performed solely to obtain sufficient material for NGS. For patients without a definitive diagnosis, 50 % did undergo at least one invasive procedure, while 11 % did not wish to undergo any invasive procedures.CONCLUSION: These insights could aid in improved LC diagnostics and efficient implementation of new techniques like liquid biopsy and artificial intelligence. This may lead to more timely LC care, a decreased number of invasive procedures, less variability between the diagnostic trajectory of different patients and aid in obtaining a definitive diagnosis for all patients.

AB - OBJECTIVES: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, adherence with existing Dutch guidelines for timeliness and type and number of invasive and imaging procedures was assessed.MATERIALS AND METHODS: 1096 patients with suspected LC were enrolled in this multicenter prospective study (NL9146). The overall survival, time from referral to the first appointment with the pulmonologist, time to diagnosis and treatment, and the number of imaging and invasive procedures were evaluated. Patients were divided into different diagnostic groupsearly- and advanced stage non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC), patients without LC and patients without a definitive diagnosis.RESULTS: The majority of patients (66 %) received a definitive diagnosis within 5 weeks, although the time to diagnosis of early-stage LC patients and patients without LC was significantly longer comparted to advanced stage LC. An increase in invasive procedures was seen for early-stage LC compared to advanced stage LC and for 13 % of the advanced stage non-squamous NSCLC patients up to three additional invasive procedures were performed solely to obtain sufficient material for NGS. For patients without a definitive diagnosis, 50 % did undergo at least one invasive procedure, while 11 % did not wish to undergo any invasive procedures.CONCLUSION: These insights could aid in improved LC diagnostics and efficient implementation of new techniques like liquid biopsy and artificial intelligence. This may lead to more timely LC care, a decreased number of invasive procedures, less variability between the diagnostic trajectory of different patients and aid in obtaining a definitive diagnosis for all patients.

KW - Diagnostic procedures

KW - Lung cancer care

KW - Survival

KW - Timeliness

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Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals

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