|Title:||Timing and Accuracy of Clinical Staging of Non-Small Lung Cancer in St James’s Hospital Tertiary Lung Cancer Referral Centre|
|Author(s):||O’Brien S 1, Dalton B1, Edwards L1, Ryan R2, Young V2, Fitzmaurice G2, Nicholson S3 O’Connell F1, Nadarajan P1. Respiratory Department SJH1, Cardiothoracic Surgery Department SJH2.Department of Histopathology3|
|Poster:||Click to view poster|
|Abstract:||The accuracy of clinical staging of non-small cell lung cancer (NSCLC) is crucial in the establishment of both prognosis and treatment pathways for patients. There can be significant discrepancies between clinical and pathological stages (1). We assessed whether the agreement of clinical and pathological stages in a real world context was similar to that of the data collected from randomised control trials (1). Delays in patient flow through diagnostic imaging can result in an increase in tumour size and stage, so we also assessed whether duration between important time points impacted the accuracy of staging of patients in our cohort. (2)|
We retrospectively collected data on 103 patients who had surgery for NSCLC in 2019. We assessed the difference between overall clinical staging and pathological staging as well as clinical and pathological T and N stages. We then constructed a timeline for each individual patient by analysing the time in days from their diagnosis to their surgery including duration between important timepoints such as PET scan and date of biopsy and EBUS.
There is agreement in the overall clinical and pathological stage in 56.7% (n=51) and disagreement in 43.3% (n=39). Median time between date of diagnosis and date of surgery was 50 and 55 days in the agreement and disagreement groups respectively. Median time between PET scan and surgery was 50 days in the agreement group and 65 days in the disagreement group.
In conclusion, the performance of our staging methodologies in a real world context is similar to that found in clinical trials. The cTNM stage agreed with pTNM stage in 56.7% of cases which is comparable to the cTNM and pTNM agreement of 52% in a large metanalysis of randomized clinical trials. Duration between PET scan and surgery may influence the accuracy of clinical staging.