WCLC 2025 - Posters & ePosters-EP.13.33 Treatment Timeliness and Impact on Survival in Extensive Stage Small Cell Lung Cancer

Pdf Summary

This Australian study assessed the impact of treatment timeliness on survival for patients with extensive-stage small cell lung cancer (ES-SCLC) using data from the Victorian Lung Cancer Registry (2012–2023). Timeliness benchmarks aligned with Australian Optimal Care Pathway guidelines defined referral-to-diagnosis interval (RDI) <28 days, diagnosis-to-treatment interval (DTI) <14 days, and referral-to-treatment interval (RTI) <42 days.<br /><br />Among 995 patients treated with chemotherapy, 87.4% met RDI, 75.7% met DTI, and 85.2% met RTI targets. Median ages were 68-69 years; most were male with varied ECOG performance status and comorbidity profiles. Most treatment occurred in public hospitals, with 44% receiving radiotherapy and 34% immunotherapy.<br /><br />Contrary to expectations, earlier diagnosis and treatment were associated with worse overall survival after adjusting for clinical factors (age, sex, performance status, comorbidities, treatment type, geography, hospital type). Hazard ratios for survival showed significantly higher risk of death when intervals were shorter than guideline benchmarks: RDI <28 days (HR ~1.3), DTI <14 days (HR ~1.3), and RTI <42 days (HR ~1.5). The authors suggest this paradoxical finding likely reflects that patients with more aggressive, symptomatic, or advanced disease undergo expedited diagnosis and treatment, rather than delay causing better outcomes.<br /><br />The study concludes most ES-SCLC patients in Victoria receive guideline-recommended timely care, but that faster treatment initiation does not improve survival. It highlights the need to consider other clinical factors influencing urgency and stresses the importance of evaluating effects on symptom management and quality of life, which were not analyzed here.<br /><br />In essence, while adherence to timeliness targets is high, earlier treatment is a marker of poorer prognosis rather than a survival benefit in ES-SCLC, underscoring the complexity of care timing and disease biology in this aggressive cancer.

Asset Subtitle

Tom John

Meta Tag

Speaker Tom John

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

Extensive-stage small cell lung cancer

ES-SCLC

Treatment timeliness

Survival outcomes

Victorian Lung Cancer Registry

Referral-to-diagnosis interval

Diagnosis-to-treatment interval

Referral-to-treatment interval

Australian Optimal Care Pathway

Chemotherapy