Association Between the Time to Surgery and Survival Among Patients With Colon Cancer: A Population-Based Study

Publication date: Available online 6 May 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Jennifer A. Flemming, Sulaiman Nanji, Xuejiao Wei, Colleen Webber, Patti Groome, Christopher M. Booth
Factors associated with time-to-surgery (TTS) and survival in colon cancer has not been well studied. Cancer Care Ontario recommends surgery within 42 days of diagnosis and that 90% of patients meet this benchmark. We describe factors associated with TTS and survival in routine clinical practice. Methods: Retrospective population-based cohort study of patients receiving elective colonic resection after diagnosis of colon cancer in Ontario, Canada from 2002-2008 followed until 2012. Factors associated with TTS were identified using multivariate log-binomial and Quantile regression at 42 days and 90^th percentiles. The association between TTS and cancer-specific (CSS) and overall survival (OS) were examined using multivariate Cox regression. Results: 4,326 patients; median age 71 years and 52% male. Median TTS was 24 days (IQR 14-37); at the 90^th percentile 56 days. Factors associated with TTS ≥ 42 days and > 90^th percentile included older age, co-morbid illness, surgeon volume, and stage I disease (P < 0.05 for all). In patients whose TTS was either at 42 days or 90^th percentile, those ≥ 80 years old waited two weeks longer than those < 60 years, individuals with co-morbid illness waited 10 days longer than without co-morbidity, and patients with stage I disease waited 10 days longer than those with stage IV disease (P < 0.05 for all). Delay in TTS > 42 days or > 90^th percentile was not associated with OS or CSS. Conclusion: Age, co-morbidity, and stage of cancer are associated with TTS. There was no association between TTS and CSS or OS.



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