A Comparative Multicenter Cohort Study Evaluating the Long-Term Influence of the Strict Lockdown during the First COVID-19 Wave on Lung Cancer Patients (ARTEMISIA Trial)
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Research Design
2.2. Inclusion/Exclusion Criteria and Collected Criteria
2.3. Statistical Methods
3. Results
3.1. Patient Characteristics
3.2. Delays for Patient Management
3.3. Survival Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Population 2019 n = 413 | Population 2020 n = 403 | ||||||
---|---|---|---|---|---|---|---|
Sex | n | 413 | 403 | 0.697 | |||
Male | n (%) | 285 | (69.0) | 273 | (67.7) | ||
Female | n (%) | 128 | (31.0) | 130 | (32.3) | ||
Age | n | 413 | 403 | 0.006 | |||
Mean age | (sd) | 65.6 ans | (10.5) | 67.6 ans | (10.3) | ||
Age ≥ or <70 years old | n | 413 | 403 | 0.002 | |||
≥70 years | n (%) | 122 | (29.5) | 160 | (39.7) | ||
<70 years | n (%) | 291 | (70.5) | 243 | (60.3) | ||
Smoking status | n | 408 | 401 | ||||
Non-smoker | n (%) | 39 | (9.6) | 64 | (15.9) | 0.006 | |
Former smoker | n (%) | 201 | (49.3) | 205 | (51.2) | ||
Active smoker | n (%) | 168 | (41.1) | 132 | (32.9) | ||
Disease discovery | n | 413 | 403 | ||||
Symptomatic patients | n (%) | 329 | (79.7) | 328 | (81.4) | 0.533 | |
Incidental finding | n (%) | 84 | (20.3) | 75 | (18.6) | ||
Type of center | n | 413 | 403 | 0.923 | |||
University Hospital | n (%) | 159 | (38.5) | 151 | (37.5) | ||
General Hospitals | n (%) | 201 | (48.7) | 197 | (48.9) | ||
Private Clinics or CCC | n (%) | 53 | (12.8) | 55 | (13.6) | ||
Symptoms | n | 314 | 315 | 0.444 | |||
Cough | n (%) | 135 | (43.0) | 128 | (40.6) | ||
Dyspnea | n (%) | 52 | (16.6) | 61 | (19.4) | ||
Pain | n (%) | 66 | (21.0) | 68 | (21.6) | ||
Hemoptysis | n (%) | 18 | (5.7) | 10 | (3.2) | ||
Neurological | n (%) | 30 | (9.6) | 28 | (8.9) | ||
Others | n (%) | 13 | (4.1) | 20 | (6.3) | ||
Histology | n | 413 | 403 | 0.688 | |||
Adenocarcinoma | n (%) | 219 | (53.0) | 216 | (53.6) | ||
SCC | n (%) | 98 | (23.7) | 99 | (24.6) | ||
SCLC | n (%) | 50 | (12.1) | 48 | (11.9) | ||
LCNEC | n (%) | 8 | (1.9) | 12 | (3.0) | ||
LCC, Nos | n (%) | 38 | (9.2) | 28 | (6.9) | ||
ECOG | n | 388 | 380 | 0.62 | |||
0–1 | n (%) | 275 | (70.8) | 257 | (67.6) | ||
2 | n (%) | 72 | (18.6) | 79 | (20.8) | ||
3–4 | n (%) | 41 | (10.6) | 44 | (11.6) | ||
Stage | n | 413 | 403 | 0.782 | |||
I–II | n (%) | 57 | (13.8) | 59 | (14.6) | ||
III | n (%) | 86 | (20.8) | 90 | (22.3) | ||
IV | n (%) | 270 | (65.4) | 254 | (63.0) | ||
Specialist type | n | 412 | 403 | 0.005 | |||
Pulmonologist | n (%) | 368 | (89.3) | 351 | (87.1) | ||
Oncologist/radiotherapist | n (%) | 14 | (3.4) | 6 | (1.5) | ||
Surgeon | n (%) | 17 | (4.1) | 38 | (10.8) | ||
Others | n (%) | 13 | (3.5) | 8 | (2.3) | ||
Diagnostic examination | n | 411 | 382 | 0.951 | |||
Bronchoscopic Fibroscopy | n (%) | 174 | (42.3) | 157 | (41.1) | ||
Image-guided biopsy | n (%) | 120 | (29.2) | 125 | (32.7) | ||
Serous puncture | 23 | (5.6) | 23 | (6.0) | |||
EBUS | 24 | (5.8) | 26 | (6.8) | |||
Exploratory surgery | n (%) | 32 | (7.8) | 30 | (7.9) | ||
Curative surgery | n (%) | 38 | (9.2) | 41 | (10.7) | ||
Molecular Alterations | n | 413 | 403 | 0.003 | |||
Absence | 327 | (74) | 328 | (70.3) | |||
EGFR | n (%) | 32 | (9.8) | 23 | (7.8) | ||
ALK/ROS1 | n (%) | 4 | (0.9) | 20 | (6.1) | ||
Others | n (%) | 50 | (15.3) | 52 | (15.8) | ||
PD-L1 TPS | n | 296 | 282 | 0.638 | |||
<1% | n (%) | 121 | (40.9) | 122 | (43.3) | ||
49–50% | n (%) | 84 | (28.4) | 70 | (24.8) | ||
≥50% | n (%) | 91 | (30.7) | 90 | (31.9) | ||
Treatments | n | 413 | 403 | 0.995 | |||
Surgery | 71 | (17.2) | 71 | (17.6) | |||
Curative radiotherapy | 8 | (1.9) | 9 | (2.2) | |||
Radiochemotherapy | 27 | (6.5) | 27 | (6.7) | |||
Systemic treatment | 247 | (59.8) | 245 | (60.8) | |||
Upfront supportive care | 60 | (14.5) | 51 | (12.6) |
Cohort | Mean Days ± Standard Deviation | Median Days (25th–75th Percentiles) | HR [CI 95%] | p | |
---|---|---|---|---|---|
Delay 1: access to imaging | 2019 | 53.8 ± 69.3 | 31 (11–76.2) | 0.89 [0.75–1.04] | 0.15 |
2020 | 61.7 ± 80.4 | 37 (14–85.8) | |||
Delay 2: access to the specialist | 2019 | 16.9 ± 24.5 | 8 (2–21) | 1.18 [1.01–1.38] | 0.048 |
2020 | 14.2 ± 28.0 | 6 (1–16) | |||
Delay 3: access to diagnosis | 2019 | 38.3 ± 37.5 | 25 (11–53) | 1.21 [1.03–1.41] | 0.022 |
2020 | 33.2 ± 40.4 | 20 (10–39) | |||
Delay 4: therapeutic decision | 2019 | 8.7 ± 34.0 | 7 (2–15) | 1.02 [0.89–1.17] | 0.78 |
2020 | 7.7 ± 28.2 | 7 (2–14) | |||
Delay 5: access to treatment | 2019 | 23.5 ± 35.6 | 17 (7–33) | 1.27 [1.09–1.47] | 0.002 |
2020 | 18.8 ± 18.1 | 14 (6–27) | |||
Delay 6: medical management | 2019 | 72.0 ± 52.2 | 59.5 (36–97) | 1.28 [1.1–1.49] | 0.001 |
2020 | 60.3 ± 41 | 50 (30.8–80) | |||
Delay 7: overall management delay | 2019 | 120 ± 84.3 | 100 (67.5–154) | 1.00 [0.84–119] | 0.97 |
2020 | 119 ± 96.5 | 97 (56.2–158) |
Characteristics | HR | 95% CI | p-Value |
---|---|---|---|
Age ≥ 70 vs. <70 | 1.29 | 1.06–1.57 | 0.01 |
Female vs. male | 0.64 | 0.52–0.78 | <0.001 |
Smoking status | |||
Non-smoker | - | ||
Current smoker | 1.73 | 1.23–2.45 | 0.002 |
Former smoker | 1.74 | 1.26–2.41 | 0.001 |
Stage | |||
I–II | - | ||
III | 3.73 | 2.28–6.1 | <0.001 |
IV | 7.75 | 4.85–12.39 | <0.001 |
PS | |||
0–1 | - | ||
2 | 2.3 | 1.84–2.84 | <0.001 |
3–4 | 4.49 | 3.45–5.85 | <0.001 |
2020 vs. 2019 | 0.71 | 0.59–0.84 | <0.001 |
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Molinier, O.; Guguen, C.; Marcq, M.; Chene, A.-L.; Masson, P.; Bigot, F.; Denis, F.; Empereur, F.; Saulnier, P.; Urban, T. A Comparative Multicenter Cohort Study Evaluating the Long-Term Influence of the Strict Lockdown during the First COVID-19 Wave on Lung Cancer Patients (ARTEMISIA Trial). Cancers 2023, 15, 5729. https://doi.org/10.3390/cancers15245729
Molinier O, Guguen C, Marcq M, Chene A-L, Masson P, Bigot F, Denis F, Empereur F, Saulnier P, Urban T. A Comparative Multicenter Cohort Study Evaluating the Long-Term Influence of the Strict Lockdown during the First COVID-19 Wave on Lung Cancer Patients (ARTEMISIA Trial). Cancers. 2023; 15(24):5729. https://doi.org/10.3390/cancers15245729
Chicago/Turabian StyleMolinier, Olivier, Camille Guguen, Marie Marcq, Anne-Laure Chene, Philippe Masson, Frédéric Bigot, Fabrice Denis, Fabienne Empereur, Philippe Saulnier, and Thierry Urban. 2023. "A Comparative Multicenter Cohort Study Evaluating the Long-Term Influence of the Strict Lockdown during the First COVID-19 Wave on Lung Cancer Patients (ARTEMISIA Trial)" Cancers 15, no. 24: 5729. https://doi.org/10.3390/cancers15245729