{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:42:33Z","timestamp":1760150553335,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The consequences of the strict health restrictions during the first wave of COVID-19 on lung cancer (LC) patients are not known. This cohort study evaluated the impact of the initial lockdown on management of and long-term outcome in LC patients. This exposed\u2013unexposed-type study included two evaluation periods of 6 months each in non-selected patients; one began on the first day of lockdown in 2020, and the other in 2019 during the same calendar period. Various indicators were compared: clinical profiles, management delays and overall survival beyond 2 years. A total of 816 patients from 7 public or private centers were enrolled. The clinical characteristics of the patients in 2020 did not differ from those in 2019, except that the population was older (p = 0.002) with more non-smokers (p = 0.006). Delays for pre-therapeutic medical management were generally reduced after the first imaging in 2020 (1.28 [1.1\u20131.49]). In the multivariate analysis, being part of the 2020 cohort was correlated with better prognosis (HR = 0.71 [0.5\u20130.84], p &lt; 0.001). The gain observed in 2020 mainly benefited non-smoking patients, along with ECOG PS 0\u20132 (p = 0.01), stage 4 (p = 0.003), squamous cell carcinoma (p = 0.03) and receiving systemic therapy (p = 0.03). In conclusion, the first lockdown did not exert any deleterious impact on LC patients.<\/jats:p>","DOI":"10.3390\/cancers15245729","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T08:48:32Z","timestamp":1701852512000},"page":"5729","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Comparative Multicenter Cohort Study Evaluating the Long-Term Influence of the Strict Lockdown during the First COVID-19 Wave on Lung Cancer Patients (ARTEMISIA Trial)"],"prefix":"10.3390","volume":"15","author":[{"given":"Olivier","family":"Molinier","sequence":"first","affiliation":[{"name":"Respiratory Medicine Department, Hospital Center, 194 Avenue Rubillard, CEDEX 9, 72037 Le Mans, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camille","family":"Guguen","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Department, Hospital Center, 194 Avenue Rubillard, CEDEX 9, 72037 Le Mans, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4044-0600","authenticated-orcid":false,"given":"Marie","family":"Marcq","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Department, Hospital Center, 85925 La Roche-sur-Yon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Laure","family":"Chene","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Department, Thorax Institute, University Hospital Center, University of Nantes, 44093 Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Masson","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Department, Hospital Center, 49300 Cholet, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Bigot","sequence":"additional","affiliation":[{"name":"Oncology Department, Western Cancer Institute Paul Papin, 49105 Angers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrice","family":"Denis","sequence":"additional","affiliation":[{"name":"Oncology Department, Clinique Victor Hugo, 72000 Le Mans, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabienne","family":"Empereur","sequence":"additional","affiliation":[{"name":"Regional Cancer Network ONCOPL, 44093 Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Saulnier","sequence":"additional","affiliation":[{"name":"Biostatistics Department, National Institute of Health and Medical Research, University of Angers, 49100 Angers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Urban","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Department, University Hospital Center, 49100 Angers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/S1470-2045(20)30265-5","article-title":"Fewer cancer diagnoses during the COVID-19 epidemic in the Netherlands","volume":"21","author":"Dinmohamed","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.ejca.2021.02.015","article-title":"New cancer cases at the time of SARS-CoV-2 pandemic and related public health policies: A persistent and concerning decrease long after the end of the national lockdown","volume":"150","author":"Kempf","year":"2021","journal-title":"Eur. J. Cancer."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1016\/S1470-2045(21)00426-5","article-title":"Estimating the impact of the COVID-19 pandemic on diagnosis and survival of five cancers in Chile from 2020 to 2030: A simulation-based analysis","volume":"22","author":"Ward","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"100134","DOI":"10.1016\/j.esmoop.2021.100134","article-title":"Delayed care for patients with newly diagnosed cancer due to COVID-19 and estimated impact on cancer mortality in France","volume":"6","author":"Blay","year":"2021","journal-title":"ESMO Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1187912","DOI":"10.3389\/fpubh.2023.1187912","article-title":"Impact of COVID-19 on cancer care pathways in a comprehensive cancer center in northern Italy","volume":"11","author":"Cigarini","year":"2023","journal-title":"Front. Public. Health"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kuzuu, K., Misawa, N., Ashikari, K., Tamura, S., Kato, S., Hosono, K., Yoneda, M., Nonaka, T., Matsushima, S., and Komatsu, T. (2023). Changes in the Number of Gastrointestinal Cancers and Stage at Diagnosis with COVID-19 Pandemic in Japan: A Multicenter Cohort Study. Cancers, 15.","DOI":"10.3390\/cancers15174410"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1091329","DOI":"10.3389\/fonc.2023.1091329","article-title":"Impact of COVID-19 444 pandemic on older cancer patients: Proposed solution by the International Geriatric Radiotherapy Group","volume":"13","author":"Nguyen","year":"2023","journal-title":"Front. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/s41571-020-00446-0","article-title":"Consequences of COVID-19 for cancer care\u2014A CRUK perspective","volume":"18","author":"Greenwood","year":"2021","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/S1470-2045(20)30388-0","article-title":"The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: A national, population-based, modelling study","volume":"21","author":"Maringe","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/j.annonc.2020.05.009","article-title":"Collateral damage: The impact on outcomes from cancer surgery of the COVID-19 pandemic","volume":"31","author":"Sud","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_11","first-page":"100769","article-title":"Proposals for managing patients with thoracic malignancies during COVID-19 pandemic","volume":"78","author":"Girard","year":"2020","journal-title":"Respir. Med. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.lungcan.2021.05.007","article-title":"Impact of COVID-19 on the management of patients with thoracic cancers in a tertiary referral center","volume":"157","author":"Basse","year":"2021","journal-title":"Lung Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1200\/OP.20.00286","article-title":"Management of Lung Cancer During the COVID-19 Pandemic","volume":"16","author":"Singh","year":"2020","journal-title":"JCO Oncol. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/j.jtho.2020.05.001","article-title":"Treatment Guidance for Patients with Lung Cancer During the Coronavirus 2019 Pandemic","volume":"15","author":"Dingemans","year":"2020","journal-title":"J. Thorac. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1016\/j.jtho.2020.04.016","article-title":"Alternative Multidisciplinary Management Options for Locally Advanced NSCLC During the Coronavirus Disease 2019 Global Pandemic","volume":"15","author":"Kumar","year":"2020","journal-title":"J. Thorac. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103120","DOI":"10.1016\/j.critrevonc.2020.103120","article-title":"Implications of COVID-19 pandemic on lung cancer management: A multidisciplinary perspective","volume":"156","author":"Bakhribah","year":"2020","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.lungcan.2020.05.029","article-title":"Optimizing lung cancer radiation treatment worldwide in COVID-19 outbreak","volume":"146","author":"Liao","year":"2020","journal-title":"Lung Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1056\/NEJMms2009984","article-title":"The Untold Toll\u2014The Pandemic\u2019s Effects on Patients without COVID-19","volume":"382","author":"Rosenbaum","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.lungcan.2021.07.002","article-title":"Care disruptions among 450 patients with lung cancer: A COVID-19 and cancer outcomes study","volume":"160","author":"Bhalla","year":"2021","journal-title":"Lung Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"100406","DOI":"10.1016\/j.esmoop.2022.100406","article-title":"Evaluation of COVID-19 impact on DELAYing diagnostic-therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): Fewer cases and higher stages from a real-world scenario","volume":"7","author":"Cantini","year":"2022","journal-title":"ESMO Open"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1097\/JTO.0b013e318217b623","article-title":"Treatment delays in non-small cell lung cancer and their prognostic implications","volume":"6","author":"Diaconescu","year":"2011","journal-title":"J. Thorac. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.lungcan.2017.07.032","article-title":"Does timeliness of care in Non-Small Cell Lung Cancer impact on survival?","volume":"112","author":"Vinod","year":"2017","journal-title":"Lung Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1016\/j.athoracsur.2015.02.022","article-title":"Effects of Delayed Surgical Resection on Short-Term and Long-Term Outcomes in Clinical Stage I Non-Small Cell Lung Cancer","volume":"99","author":"Samson","year":"2015","journal-title":"Ann. Thorac. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.amjmed.2013.12.023","article-title":"Survival after community diagnosis of early-stage non-small cell lung cancer","volume":"127","author":"Kanarek","year":"2014","journal-title":"Am. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1503\/cjs.007015","article-title":"Is it safe to wait? The effect of surgical wait time on survival in patients with non-small cell lung cancer","volume":"58","author":"Coughlin","year":"2015","journal-title":"Can. J. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ejca.2022.06.018","article-title":"Influence of the SARS-CoV-2 outbreak on management and prognosis of new lung cancer cases, 453 a retrospective multicentre real-life cohort study","volume":"173","author":"Priou","year":"2022","journal-title":"Eur. J. Cancer"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e362","DOI":"10.1016\/j.cllc.2022.05.001","article-title":"Extended Delay to Treatment for Stage III-IV Non-Small-Cell Lung Cancer and Survival: Balancing Risks During the COVID-19 Pandemic","volume":"23","author":"Mayne","year":"2022","journal-title":"Clin. Lung Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4247","DOI":"10.3390\/curroncol28060360","article-title":"The Impact of COVID-19 on the Diagnosis and Treatment of Lung Cancer at a Canadian Academic Center: A Retrospective Chart Review","volume":"28","author":"Kasymjanova","year":"2021","journal-title":"Curr. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100492","DOI":"10.1016\/j.lanepe.2022.100492","article-title":"Lung cancer trends and tumor characteristic changes over 20 years (2000\u20132020): Results of three French consecutive nationwide prospective cohorts\u2019 studies","volume":"22","author":"Debieuvre","year":"2022","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1002\/onco.13962","article-title":"Clinical Impact of the COVID-19 Pandemic in Mexican Patients with Thoracic Malignancies","volume":"26","author":"Arrieta","year":"2021","journal-title":"Oncologist"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S775","DOI":"10.1016\/j.annonc.2022.07.637","article-title":"COVID-19 disease among lung cancer (LC) patients: Data from a real-life prospective multicentric study","volume":"33","author":"Molinier","year":"2022","journal-title":"Ann. Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/24\/5729\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:34:12Z","timestamp":1760132052000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/24\/5729"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,6]]},"references-count":31,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["cancers15245729"],"URL":"https:\/\/doi.org\/10.3390\/cancers15245729","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2023,12,6]]}}}