P1.12-05 Prediction of Clinically Significant Pathological Upstaging in Resected Lung Cancer: Insight from COVID-19 Pandemic (1st wave)

IntroductionWe aim to investigate clinicopathological characteristics of our surgical lung cancer population presenting during the 1st wave of pandemic, describe the key service parameters, and to identify pathological upstaging compared to a pre-pandemic cohort.MethodsThis is part of an ongoing observational study including all primary lung cancer patients who underwent resection at our centre. Data were collected as part of an institutional lung cancer database. COVID vulnerability status was derived from Department of Health (UK) guidelines. Clinically significant pathological upstaging was defined as migration between clinical and pathological final TNM stage, either major (between stages) or minor (between substages except IA). Logistic regression was employed to identify independent predictors of upstaging, and a 3-tier risk stratification system was developed.ResultsWe included 242 cases from 1st wave and 456 cases from a 2019 cohort. Radiological lesion size, nodal status, Maximum Standard Unit Value (SUVmax) and histological risk group were independent predictors of upstaging. The 3-tier system stratified such risk into low (8.3%), intermediate (26.1%) and high (48.4%), with AUC of 0.683. There was 20.4% reduction in caseload, and significant drop in all-purpose frozen section usage. No significant difference was seen regarding patients classified as clinically extremely vulnerable (CEV), clinically vulnerable (CV) as well as multimorbidity. No significant changes were observed for surgical waiting time, histological subtypes, final pathological stage, R0 resection or clinically significant upstaging (30.1% vs 30.2%), but there was minor impact on pathology reporting times.ConclusionsView Large Image Figure ViewerDownload Hi-res image Download (PPT)KeywordsLung cancer, Pathological upstaging, COVID-19 IntroductionWe aim to investigate clinicopathological characteristics of our surgical lung cancer population presenting during the 1st wave of pandemic, describe the key service parameters, and to identify pathological upstaging compared to a pre-pandemic cohort.