Objectives To determine whether surgical wait time impacts survival in patients with endometrial cancer (EC).
Methods A retrospective analysis was performed, including all patients diagnosed with EC between 2008 and 2015 treated in a single centre in Montreal. Associations between surgery wait times and other variables were calculated using univariable linear regression models. In survival analysis, Cox proportional hazard models were used to calculate hazard ratios (HR); covariates included age, BMI, year of diagnosis, ECOG score, and tumor histology, grade and stage at surgery.
Results The study included 358 patients with median follow-up of 5.9 years, categorized into four groups based on their wait time: 89, 87, 91, and 91 women with a median wait time of 37 days (8–49), 62 days (50–70), 91 days (71–103), and 91 days (104–869), respectively. Increased surgical wait time was associated with lymph-vascular space invasion and distant metastases. A surgery delay of 71 days or more (median) did not result in significantly worse overall (p=0.54) or EC specific survival (p=0.27), while known prognostic variables such as stage and grade at surgery did (p<0.05). In a subgroup analyses, patients with grade II tumors who had more than 71 days between biopsy and surgery (n=51) had significantly (P=0.037) more EC-related mortality (5-year cancer-specific survival 83.9%, versus 100% for those with surgery within 70 days). Similarly, surgery delay had impact on overall survival also in patients with BMI>30 (HR 1.43, 95% CI 1.00–2.03).
Conclusions While surgery delay might predict outcome in specific subgroups, biological tumor determinants seems more important for survival outcome.
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