Delay to Colectomy and Survival for Patients Diagnosed with Colon Cancer. Issue 4 (19th May 2019)

• Record Type: Journal Article
• Authors: Bagaria, Sanjay P.; Heckman, Michael G.; Diehl, Nancy N.; Parker, Alexander; Wasif, Nabil
• Is Part Of: Journal of investigative surgery. Volume 32:Issue 4(2019)
• Page Start: 350
• Page End: 357
• Publication Date: 2019-05-19
• Subjects: colon cancer -- delay -- surgery; Surgery -- Research -- Periodicals; Research; Surgery; Surgical Procedures, Operative; 617.075
• DOI: 10.1080/08941939.2017.1421732
• Languages: English
• ISSNs: 0894-1939

Abstract

ABSTRACT: Background : A long wait-time for colectomy for colon cancer should theoretically affect survival but, to date, the association between delay to colectomy and survival remains unresolved. Methods : We studied 4, 685 patients who underwent a colectomy for colon cancer between 1990 and 2012. Wait-time was defined as the number of days between diagnosis and colectomy. Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality. Results : The number of patients in the wait-time group of 1–21 days was 3, 529 (75.3%), 22–42 days was 842 (18.0%), 43–84 days was 253 (5.4%), and >84 days was 61 (1.3%). When compared to patients undergoing surgery in the first week after diagnosis, there was no increased risk of death until wait time >84 days (HR = 1.47; 95% CI, 1.02–2.11; p =.038). Patients in the wait time >84 day group tended to be older, traveled further for colectomy, and had tumors with a lower histologic grade. Conclusions : Colectomy for colon cancer performed up to 3 months following diagnosis is not associated with adverse long-term survival. These data provide a framework to address concerns over prolonged wait-times and direct efforts for timely surgery in patients with colon cancer.