Abstract
Purpose: To assess the impact of delay from diagnosis to curative surgery on survival in patients with non-metastatic colon cancer. Methods: National Cancer database (NCDB) analysis (2004–2013) including all consecutive patients diagnosed with stage I-III colon cancer and treated with primary elective curative surgery. Short and long delays were defined as lower and upper quartiles of time from diagnosis to treatment, respectively. Age-, sex-, race-, tumor stage and location-, adjuvant treatment-, comorbidity- and socioeconomic factors-adjusted overall survival (OS) was compared between the two groups (short vs. long delay). A multivariable Cox regression model was used to identify the independent impact of each factor on OS. Results: Time to treatment was <16 days in the short delay group (31,171 patients) and ≥37 days in the long delay group (29,617 patients). OS was 75.4 vs. 71.9% at 5 years and 56.6 vs. 49.7% at 10 years in short and long delay groups, respectively (both p < 0.0001). Besides demographic (comorbidities, advanced age) and pathological factors (transverse and right-vs. left-sided location, advanced tumor stage, poor differentiation, positive microscopic margins), treatment delay had a significant impact on OS (HR 1.06, 95% CI 1.05–1.07 per 14 day-delay) upon multivariable analysis. The adjusted hazard ratio for death increased continuously with delay times of longer than 30 days, to become significant after a delay of 40 days. Conclusion: This analysis using a national cancer database revealed a significant impact on OS when surgeries for resectable colon cancer were delayed beyond 40 days from time of diagnosis.
Original language | English (US) |
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Pages (from-to) | 455-461 |
Number of pages | 7 |
Journal | European Journal of Surgical Oncology |
Volume | 46 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2020 |
Keywords
- Colon cancer
- Survival
- Treatment delay
ASJC Scopus subject areas
- Surgery
- Oncology