ObjectiveTo investigate the timing of adjuvant chemotherapy initiation after lung cancer surgery and factors associated with delayed initiation. MethodsClinical data of patients scheduled to receive platinum-based adjuvant chemotherapy after radical lung cancer surgery at the Department of Thoracic Surgery, Zhujiang Hospital, Southern Medical University, from September 2024 to December 2025 were retrospectively collected. The time to adjuvant chemotherapy was defined as the interval from surgery to the first administration of adjuvant chemotherapy. The 75th percentile of this cohort, 48 days, was used as an exploratory cutoff to divide patients into non-delayed and delayed groups. Pain, dyspnea, sleep disturbance, and fatigue were assessed using the MD Anderson Symptom Inventory from postoperative days 2 to 7, and the maximum score for each symptom was used for analysis. Firth-corrected logistic regression was used to identify factors associated with delayed initiation. ResultsA total of 61 patients were included, with a median age of 63.00 years (interquartile range, 53.00-68.00 years), and 52 (85.2%) were male. The median time to adjuvant chemotherapy was 38 days, and 17 (27.9%) patients experienced delayed initiation. Compared with the non-delayed group, the delayed group had a higher sleep disturbance score [6.0 (3.0, 7.0) vs. 4.0 (3.0, 5.0), P=0.021], and showed a trend toward a higher incidence of postoperative complications [35.3% (6/17) vs. 11.4% (5/44), P=0.058] and fatigue scores [5.0 (3.0, 6.0) vs. 3.5 (2.0, 5.0), P=0.076]. Multivariable analysis showed that postoperative complications were independently associated with delayed initiation [aOR=4.27, 95%CI (1.05, 18.85), P=0.042]. ConclusionManagement and timely intervention of postoperative complications are essential for facilitating the timely transition to adjuvant chemotherapy, and early postoperative symptom monitoring may help optimize perioperative management and promote the scheduled continuation of subsequent treatment.
Objective To explore the timing and safety of limited-period lung cancer surgery in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods Clinical data of of patients infected with COVID-19 undergoing lung cancer surgery (an observation group) in the Department of Thoracic Surgery of Guangdong Provincial People's Hospital, the Department of Thoracic Surgery of General Hospital of Southern Theater Command of PLA, and the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Guangdong Pharmaceutical University from December 2022 to January 2023 were retrospectively analyzed and compared with patients who underwent surgery during the same period but were not infected with COVID-19 (a control group), to explore the impact of COVID-19 infection on lung cancer surgery. Results We finally included 110 patients with 73 patients in the observation group (28 males and 45 females at age of 52.62±12.80 years) and 37 patients in the control group (22 males and 15 females at age of 56.84±11.14 years). The average operation time of the observation group was longer than that of the control group, and the incidence of anhelation was higher than that of the control group (P<0.05). There were no statistcal differences in blood loss, length of hospital stay, moderate or above fever rate, degree of cough and chest pain, or blood routine between the two groups. ConclusionIt is safe and feasible to perform lung cancer surgery early after recovery for COVID-19 patients with lung cancer.