Background: The COVID-19 pandemic prompted concerns about delays in cancer diagnosis and treatment, particularly for lung cancer (LC). We assessed the impact of the pandemic on lung cancer care, diagnostic efficiency, treatment timelines, and short-term survival in a Spanish tertiary hospital.Methods: We performed a retrospective cohort study including 530 patients diagnosed with primary lung cancer from March 2019 to March 2022. Patients were grouped into three cohorts: pre-pandemic (2019), first pandemic year (2020), and second pandemic year (2021). Key intervals—referral-to-diagnosis and diagnosis-to-treatment—along with survival outcomes were compared across cohorts. Multivariate Cox regression identified independent predictors of mortality.Results: LC diagnoses declined by 19% in 2020, rebounding by 42% in 2021. The proportion of patients receiving the first definitive treatment remained stable (~70%). Diagnostic timeliness improved: the median referral-to-diagnosis interval shortened from 19 to 14 days (p< 0.0001), with >80% of patients diagnosed within 30 days throughout all periods. Molecular testing turnaround increased (median 11 to 15 days,p= 0.0226). The diagnosis-to-treatment interval remained unchanged (median 34–35 days). One-year survival improved from 37% (2019) to 43% (2020–2021), and two-year survival from 22% to 30%. In multivariate analysis, only advanced stage and poor ECOG performance status independently predicted mortality; delays in diagnosis or treatment had no significant impact.Conclusions: Despite pandemic-related disruptions, essential LC care and short-term outcomes were largely maintained in our center. Early stage at diagnosis and favorable performance status outweighed the effect of moderate delays. Health system resilience and streamlined care pathways proved critical for sustaining cancer outcomes during the COVID-19 crisis. These findings offer actionable lessons for the Spanish healthcare system and may help guide national preparedness strategies for future oncologic crises.
背景：COVID-19大流行引发了对癌症（尤其是肺癌）诊断与治疗延迟的担忧。本研究旨在评估疫情对西班牙某三级医院肺癌诊疗流程、诊断效率、治疗时效及短期生存率的影响。 方法：我们开展了一项回顾性队列研究，纳入2019年3月至2022年3月期间确诊的530例原发性肺癌患者。将患者分为三个队列：疫情前（2019年）、疫情第一年（2020年）和疫情第二年（2021年）。比较各队列的关键时间间隔（转诊至确诊间隔、确诊至治疗间隔）及生存结局，并通过多变量Cox回归分析确定死亡的独立预测因素。 结果：2020年肺癌诊断量下降19%，2021年反弹增长42%。接受首次根治性治疗的患者比例保持稳定（约70%）。诊断及时性有所改善：转诊至确诊中位时间从19天缩短至14天（p<0.0001），各时期超过80%的患者在30天内获得诊断。分子检测周期延长（中位时间从11天增至15天，p=0.0226）。确诊至治疗间隔保持稳定（中位34-35天）。一年生存率从37%（2019年）提升至43%（2020-2021年），两年生存率从22%提升至30%。多变量分析显示，仅晚期分期和较差的ECOG体能状态是死亡的独立预测因素，诊断或治疗延迟未产生显著影响。 结论：尽管受到疫情干扰，本中心的肺癌核心诊疗流程与短期结局基本得以维持。早期诊断和良好体能状态的作用超过了适度延迟的影响。医疗系统的应变能力和优化后的诊疗路径对维持癌症结局至关重要。这些发现为西班牙医疗体系提供了可操作的实践经验，有助于指导未来肿瘤危机应对的国家级准备策略。
肿瘤(癌症)患者之家