Impact of delay to surgery on survival in stage I-III colon cancer
To assess the impact of delay from diagnosis to curative surgery on survival in patients with non-metastatic colon cancer. National Cancer database (NCDB) analysis (2004–2013) including all consecutive patients diagnosed with stage I-III colon cancer and treated with primary elective curative surger...
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| Veröffentlicht in: | European journal of surgical oncology 2020-03, Vol.46 (3), p.455-461 |
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| creator | Grass, Fabian Behm, Kevin T. Duchalais, Emilie Crippa, Jacopo Spears, Grant M. Harmsen, William S. Hübner, Martin Mathis, Kellie L. Kelley, Scott R. Pemberton, John H. Dozois, Eric J. Larson, David W. |
| description | To assess the impact of delay from diagnosis to curative surgery on survival in patients with non-metastatic colon cancer.
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.
Time to treatment was |
| doi_str_mv | 10.1016/j.ejso.2019.11.513 |
| format | Article |
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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.
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.
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.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2019.11.513</identifier><identifier>PMID: 31806516</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aged ; Colon cancer ; Colonic Neoplasms - diagnosis ; Colonic Neoplasms - mortality ; Colonic Neoplasms - surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival ; Survival Rate - trends ; Time-to-Treatment ; Treatment delay ; United States - epidemiology</subject><ispartof>European journal of surgical oncology, 2020-03, Vol.46 (3), p.455-461</ispartof><rights>2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology</rights><rights>Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-bb49a5a81701da5512a1ee66a22dd48281851efb4f2de03504851ffaca75a42d3</citedby><cites>FETCH-LOGICAL-c466t-bb49a5a81701da5512a1ee66a22dd48281851efb4f2de03504851ffaca75a42d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0748798319314647$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31806516$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grass, Fabian</creatorcontrib><creatorcontrib>Behm, Kevin T.</creatorcontrib><creatorcontrib>Duchalais, Emilie</creatorcontrib><creatorcontrib>Crippa, Jacopo</creatorcontrib><creatorcontrib>Spears, Grant M.</creatorcontrib><creatorcontrib>Harmsen, William S.</creatorcontrib><creatorcontrib>Hübner, Martin</creatorcontrib><creatorcontrib>Mathis, Kellie L.</creatorcontrib><creatorcontrib>Kelley, Scott R.</creatorcontrib><creatorcontrib>Pemberton, John H.</creatorcontrib><creatorcontrib>Dozois, Eric J.</creatorcontrib><creatorcontrib>Larson, David W.</creatorcontrib><title>Impact of delay to surgery on survival in stage I-III colon cancer</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>To assess the impact of delay from diagnosis to curative surgery on survival in patients with non-metastatic colon cancer.
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.
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.
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.</description><subject>Aged</subject><subject>Colon cancer</subject><subject>Colonic Neoplasms - diagnosis</subject><subject>Colonic Neoplasms - mortality</subject><subject>Colonic Neoplasms - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Survival Rate - trends</subject><subject>Time-to-Treatment</subject><subject>Treatment delay</subject><subject>United States - epidemiology</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtPwzAQhC0EoqXwBzigHLkkeO04D4kLVDwiVeICZ8uxN1WipC52Wqn_HkctHDntrHZmpP0IuQWaAIXsoUuw8zZhFMoEIBHAz8gcBGcxA5GfkznN0yLOy4LPyJX3HaW05Hl5SWYcCpoJyObkuRq2So-RbSKDvTpEo438zq3RHSK7meS-3as-aoMe1RqjKq6qKtK2D1etNhrdNbloVO_x5jQX5Ov15XP5Hq8-3qrl0yrWaZaNcV2npRKqgJyCUUIAU4CYZYoxY9KCFVAIwKZOG2aQckHTsDeN0ioXKmWGL8j9sXfr7PcO_SiH1mvse7VBu_OSccZyXgpKg5UdrdpZ7x02cuvaQbmDBCondrKTEzs5sZMAMrALobtT_64e0PxFfmEFw-PRgOHLfYtOet1iQGBah3qUxrb_9f8A-7d-kA</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Grass, Fabian</creator><creator>Behm, Kevin T.</creator><creator>Duchalais, Emilie</creator><creator>Crippa, Jacopo</creator><creator>Spears, Grant M.</creator><creator>Harmsen, William S.</creator><creator>Hübner, Martin</creator><creator>Mathis, Kellie L.</creator><creator>Kelley, Scott R.</creator><creator>Pemberton, John H.</creator><creator>Dozois, Eric J.</creator><creator>Larson, David W.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202003</creationdate><title>Impact of delay to surgery on survival in stage I-III colon cancer</title><author>Grass, Fabian ; Behm, Kevin T. ; Duchalais, Emilie ; Crippa, Jacopo ; Spears, Grant M. ; Harmsen, William S. ; Hübner, Martin ; Mathis, Kellie L. ; Kelley, Scott R. ; Pemberton, John H. ; Dozois, Eric J. ; Larson, David W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-bb49a5a81701da5512a1ee66a22dd48281851efb4f2de03504851ffaca75a42d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Colon cancer</topic><topic>Colonic Neoplasms - diagnosis</topic><topic>Colonic Neoplasms - mortality</topic><topic>Colonic Neoplasms - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Survival</topic><topic>Survival Rate - trends</topic><topic>Time-to-Treatment</topic><topic>Treatment delay</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grass, Fabian</creatorcontrib><creatorcontrib>Behm, Kevin T.</creatorcontrib><creatorcontrib>Duchalais, Emilie</creatorcontrib><creatorcontrib>Crippa, Jacopo</creatorcontrib><creatorcontrib>Spears, Grant M.</creatorcontrib><creatorcontrib>Harmsen, William S.</creatorcontrib><creatorcontrib>Hübner, Martin</creatorcontrib><creatorcontrib>Mathis, Kellie L.</creatorcontrib><creatorcontrib>Kelley, Scott R.</creatorcontrib><creatorcontrib>Pemberton, John H.</creatorcontrib><creatorcontrib>Dozois, Eric J.</creatorcontrib><creatorcontrib>Larson, David W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grass, Fabian</au><au>Behm, Kevin T.</au><au>Duchalais, Emilie</au><au>Crippa, Jacopo</au><au>Spears, Grant M.</au><au>Harmsen, William S.</au><au>Hübner, Martin</au><au>Mathis, Kellie L.</au><au>Kelley, Scott R.</au><au>Pemberton, John H.</au><au>Dozois, Eric J.</au><au>Larson, David W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of delay to surgery on survival in stage I-III colon cancer</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2020-03</date><risdate>2020</risdate><volume>46</volume><issue>3</issue><spage>455</spage><epage>461</epage><pages>455-461</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><abstract>To assess the impact of delay from diagnosis to curative surgery on survival in patients with non-metastatic colon cancer.
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.
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.
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.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>31806516</pmid><doi>10.1016/j.ejso.2019.11.513</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Colon cancer Colonic Neoplasms - diagnosis Colonic Neoplasms - mortality Colonic Neoplasms - surgery Female Follow-Up Studies Humans Male Middle Aged Neoplasm Staging Prognosis Retrospective Studies Survival Survival Rate - trends Time-to-Treatment Treatment delay United States - epidemiology |
| title | Impact of delay to surgery on survival in stage I-III colon cancer |
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