In an abstract presented at the 2024 National Comprehensive Cancer Network Annual Conference, Atharv Sharma, BEng (Hons), and colleagues conducted a study on the real-world ramifications of delayed surgical intervention in early-stage non–small cell lung cancer (eNSCLC). The findings shed light on the complex relationship between timing of surgery, patient outcomes, and health care resource utilization.

Early-stage lung cancer patients often encounter delays in receiving care, imposing an added strain on the health care system. This study aimed to evaluate the tangible impact of delayed surgery on health care resource use among patients with eNSCLC.

Looking at KOMODO claims data, researchers examined a cohort of 19 167 patients with eNSCLC diagnosed between 2021 and 2022 who underwent surgery. Key metrics assessed included time to metastasis, incidence of hospitalization, and health care cost utilization within one year post-surgery. Delayed surgery was operationally defined as surgical intervention occurring after 12 weeks without initiation of neoadjuvant treatment or after 6 weeks with neoadjuvant treatment initiation. Propensity score matching was employed to balance baseline characteristics such as age, gender, race, ethnicity, and comorbidities related to various organ systems.

Among the analyzed patient population, 14% (2712 individuals) experienced delayed surgery. Propensity score matching mitigated baseline characteristic imbalances. Patients undergoing delayed surgery exhibited a progression to metastasis rate of 20.28%, slightly lower than the 23.04% observed in patients without delay. Survival curve analysis revealed no significant disparities between the two groups. Cox multivariate regression affirmed the lack of significant differences in disease progression between delayed and non-delayed surgery groups (hazard ratio = 1.05; 95% CI = 0.93-1.18; P = .43). However, patients subjected to delayed surgery demonstrated a 1.08 times higher rate of postsurgical hospitalization occurrence within one year (incidence rate ratio = 1.08; 95% CI = 1.06-1.10; P <.001). On average, delayed surgery patients incurred health care resource utilization costs totaling $62,094±$47,467.51, compared to $57,287±$45,665.50 for those without delays. This translated to an average excess expenditure of $4,806.84±$1,264.81 in patients with delayed surgery (P <.001).

While delayed surgery did not exhibit a significant impact on eNSCLC patient outcomes, it significantly influenced health care resource utilization. The study highlights the substantial burden of care gaps on health care resources, emphasizing the critical importance of decision-making regarding treatment delays for patients with early-stage lung cancer. 

Source: 
 
Sharma A, Prasad M, Hu T, et al. Estimation of impact of care gap on patient outcome and health care cost burden using real world data in early-stage NSCLC—an empirical study for delay in surgery. Presented at the 2024 National Comprehensive Cancer Network Annual Conference; April 5-April 7, 2024. Orlando, Florida, and virtual.