Real-World Evidence of the Impact of the COVID-19 Pandemic on Lung Cancer Survival: Canadian Perspective
Abstract
:1. Introduction
2. Materials and Methods
2.1. Population
- Cohort #1 (2019): Pre-COVID-19
- Cohort #2 (2020): 1st year of COVID-19
- Cohort #3 (2021): 2nd year of COVID-19
2.2. Objectives
2.3. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Front-Line Treatment
3.3. Lung Cancer Mortality and Survival
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study Cohorts | Included in the Study | Second Opinion (Excluded) | Total | p Value |
---|---|---|---|---|
Cohort 1 (2019) | 130 | 40 | 170 | 0.004 |
Cohort 2 (2020) | 103 | 8 | 111 | |
Cohort 3 (2021) | 184 | 35 | 219 | |
Total | 417 | 83 | 500 |
Characteristics | 2019 n = 130 | 2020 n = 103 | 2021 n = 184 | ||
---|---|---|---|---|---|
Age (mean; range) | 70 (40–96) | 71 (42–92) | 71 (41–92) | 0.991 | |
Sex n (%) | Male | 73 (56) | 56 (54) | 88 (48) | 0.145 |
Female | 57 (44) | 47 (46) | 96 (52) | ||
Smoking n (%) | Former/current | 99 (76) | 74 (74) | 156 (85) | 0.054 |
Non-smoker | 31 (24) | 29 (26) | 28 (15) | ||
ECOG PS n (%) | 0–1 | 106 (82) | 84 (82) | 148 (80) | 0.960 |
>1 | 24 (18) | 19 (18) | 36 (20) | ||
Stage | Early 1 | 42 (32) | 33(32) | 55 (30) | 0.787 |
Locoregional 2 | 20 (15) | 11 (11) | 29 (16) | ||
Advanced/Metastatic 3 | 68 (52) | 59 (57) | 100 (54) |
M Status | Cohort 1 n = 68 | Cohort 2 n = 59 | Cohort 3 n = 100 |
---|---|---|---|
M1a 1 n (%) | 20 (29) | 14 (24) | 31 (31) |
M1b 2 n (%) | 27 (40) | 11 (19) | 18 (18) |
M1c 3 n (%) | 21 (31) | 34 (57) | 51 (51) |
The two-tailed p value (2020 vs. 2019) | 0.002 | ||
The two-tailed p value (2021 vs. 2019) | 0.013 |
Type of FTD | Cohort 1 n = 110 | Cohort 2 n = 84 | Cohort 3 n = 151 | p-Value | |
---|---|---|---|---|---|
Surgery (n/%) | 42 (38) | 24 (29) | 54 (36) | 0.01 | |
Radiosurgery (n/%) | 8 (7) | 20 (24) | 12 (8) | 0.009 | |
CTX 2 (n/%) | Total | 60 (54) | 40 (47) | 85 (56) | >0.05 |
SOC 1 | 20 (33) | 12 (30) | 25 (29) | ||
IO ± CTX 3 | 23 (38) | 16 (40) | 37 (44) | ||
Targeted CTX | 17 (29) | 12 (30) | 23 (27) |
Stage | Cohort | n | Died at 6 Months n (%) | p Value |
---|---|---|---|---|
Early stage 1 | 1 (2019) | 42 | 1 (2) | |
2 (2020) | 33 | 3 (9) | >0.05 | |
3 (2021) | 55 | 0 (0) | ||
Locoregional 2 | 1 (2019) | 20 | 3 (15) | 0.407 |
2 (2020) | 11 | 3 (27) | ||
3 (2021) | 29 | 4 (14) | ||
Advanced/metastatic stage 3 | 1 (2019) | 68 | 20 (29) | 0.004 |
2 (2020) | 59 | 28 (47) | ||
3 (2021) | 100 | 53 (53) |
Model #1 Description | Variables Included in the Model | Reference | Exp(B) | 95% CI | p Value |
All subjects | Year of diagnosis | 2019 | 1.098 | 0.926–1.302 | 0.284 |
Age | ≤65 | 1.024 | 1.021–1.269 | 0.005 | |
Events = 199 | Sex | Female | 1.106 | 0.824–1.485 | 0.502 |
Censored = 218 | ECOG PS | 0–1 | 2.360 | 1.721–3.237 | <0.001 |
Missing = 0 | Smoking | Smoker | 0.729 | 0.598–0.897 | 0.002 |
Total = 417 | Stage | 1–3A | 3.438 | 2.663–4.438 | <0.001 |
Model #2 Description | Variables Included in the Model | Exp(B) | 95% CI | p Value | |
Advanced/metastatic stage | Year of diagnosis | 2019 | 1.156 | 1.021–1.393 | 0.042 |
Age | ≤65 | 1.035 | 1.018–1053 | <0.001 | |
Events = 167 | Sex | Female | 1.108 | 0.803–1.530 | 0.532 |
Censored = 60 | ECOG PS | 0–1 | 2.483 | 1.780–3.463 | <0.001 |
Total = 227 | Smoking | Smoker | 0.723 | 0.584–0.894 | <0.001 |
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Agulnik, J.; Kasymjanova, G.; Pepe, C.; Friedmann, J.; Small, D.; Sakr, L.; Wang, H.; Spatz, A.; Sultanem, K.; Cohen, V. Real-World Evidence of the Impact of the COVID-19 Pandemic on Lung Cancer Survival: Canadian Perspective. Curr. Oncol. 2024, 31, 1562-1571. https://doi.org/10.3390/curroncol31030119
Agulnik J, Kasymjanova G, Pepe C, Friedmann J, Small D, Sakr L, Wang H, Spatz A, Sultanem K, Cohen V. Real-World Evidence of the Impact of the COVID-19 Pandemic on Lung Cancer Survival: Canadian Perspective. Current Oncology. 2024; 31(3):1562-1571. https://doi.org/10.3390/curroncol31030119
Chicago/Turabian StyleAgulnik, Jason, Goulnar Kasymjanova, Carmela Pepe, Jennifer Friedmann, David Small, Lama Sakr, Hangjun Wang, Alan Spatz, Khalil Sultanem, and Victor Cohen. 2024. "Real-World Evidence of the Impact of the COVID-19 Pandemic on Lung Cancer Survival: Canadian Perspective" Current Oncology 31, no. 3: 1562-1571. https://doi.org/10.3390/curroncol31030119