2022 World Conference on Lung Cancer (Posters)-P1.12-05. Prediction of Clinically Significant Pathological Upstaging in Resected Lung Cancer: Insight from COVID-19 Pandemic (1st Wave)

P1.12-05. Prediction of Clinically Significant Pathological Upstaging in Resected Lung Cancer: Insight from COVID-19 Pandemic (1st Wave)

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This study examines the impact of the first wave of the COVID-19 pandemic on surgical lung cancer services and the risk of pathological upstaging. The researchers found that there was a significant reduction in caseload during the pandemic, but no significant difference in the clinical vulnerability or comorbidity status of patients. They also observed a decrease in the usage of frozen sections and an increase in the proportion of wedge resection/segmentectomy procedures. However, there was no significant difference in surgical waiting times, tumor types and stages, quality of resection, and frequency of pathological upstaging.<br /><br />Despite the reduced caseload, there were early trends of delays in pathology reporting, as evidenced by drops in the fulfillment of 7-day and 10-day target turnaround times. Pathological upstaging was not uncommon, occurring in approximately one-third of resected lung cancer cases.<br /><br />The researchers developed a predictive tool for clinically significant pathological upstaging based on routinely available pre-treatment patient data. The tool utilizes variables such as tumor size, clinical nodal status, maximum standardized uptake value (SUVmax), and tumor risk group to stratify the risk of upstaging. They found that the tool had good discriminatory performance with an area under the curve (AUC) of 0.703.<br /><br />In conclusion, the first wave of the COVID-19 pandemic resulted in a decrease in surgical caseload but did not significantly impact clinicopathological characteristics, surgical service parameters, or the risk of pathological upstaging. The study also developed a practical and accessible tool for predicting clinically significant pathological upstaging that may aid in patient prioritization and the transition to risk-based management of lung cancer in the post-pandemic era.

Asset Subtitle

Yu Zhi Zhang, United Kingdom

Meta Tag

Speaker Yu Zhi Zhang, United Kingdom

Topic Management of Lung Cancer in the Era of COVID-24

Keywords

COVID-19 pandemic

surgical lung cancer services

pathological upstaging

caseload reduction

frozen sections

wedge resection

surgical waiting times

predictive tool

clinically significant upstaging

patient prioritization