Evaluating Treatment strategies for Non-small Cell Lung Cancer during COVID-19: A Propensity Scores Matching Analysis

Abstract Background We had different understanding of treatment strategies to which we preferred conduct surgery for early-stage patients and delay treatment for late-stage non-small cell lung cancer patients at beginning of the COVID-19 pandemic. However, as we learned more about other guidelines, we were not sure whether our strategies have caused adverse results. Methods We divided patients hospitalized from September 2019 to February 2020 into experimental and control groups, and evaluated treatment strategies by patients’ prognosis. Propensity scores matching was used to adjust selection bias. Results Therapy discontinuation in the experimental group were significantly higher than the control group (P༜0.001). The differences of cancer progression and the number of deaths between the two groups were not significant (P = 0.376, 0.128, respectively). There were significant differences in non-surgical treatment and discontinued therapy for late-stage patients (P༜0.001, ༜0.001, respectively), while the differences of surgical treatment and therapy discontinuance for early-stage patients were not significant (P = 0.243, 0.243, respectively). The cancer progression and death toll differences in both early and late stage between the two groups were not significant (P = 0.608, 0.489, 0.197, 0.197, respectively). Multivariate analysis revealed therapy discontinuation did not predicted progress-free survival independently (hazard ratio = 1.007, 95% confidence interval: 0.653–1.552, P = 0.976). Conclusions For patients in regions with low risk for COVID-19 infections, surgery should not be delayed for early-stage patients if the hospital has adequate medical resources and strict testing and prevention measures are utilized. Delaying treatment less than three months can not significantly impact the prognosis of late-stage non-small cell lung cancer patients.