TY - JOUR
T1 - Influence of delays to nonemergent colon cancer surgery on operative mortality, disease-specific survival and overall survival
AU - Simunovic, Marko
AU - Rempel, Eddy
AU - Thériault, Marc Erick
AU - Baxter, Nancy N.
AU - Virnig, Beth A.
AU - Meropol, Neal J.
AU - Levine, Mark N.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2009/8
Y1 - 2009/8
N2 - Background: There has been minimal research on the influence of delays for cancer treatments on patient outcomes. We measured the influence of delays to nonemer- gent colon cancer surgery on operative mortality, disease-specific survival and overall survival. Methods: We used the linked Surveillance, Epidemiology and End Results (SEER)- Medicare databases (1993-1996) to identify patients who underwent nonemergent colon cancer surgery. We assessed 2 time intervals: surgeon consult to hospital admission for surgery and first diagnostic test for colon cancer to hospital admission. Follow- up data were available to the end of 2003. We selected the time intervals to create patient groups with clinical relevance and they did not extend past 120 days. Results: We identified 7989 patients who underwent nonemergent colon cancer surgery. Median delays from surgeon consult to admission and from first diagnostic test to admission were 7 and 17 days, respectively. The odds of operative mortality were similar if the consult-to-admission interval was 22 days or more versus 1-7 days (odds ratio [OR] 1.0, 95% confidence interval [CI] 0.6-1.8, p = 0.91) or if the test-to- admission interval was 43 days or more versus 1-14 days (OR 0.8, 95% CI 0.4-1.5, p = 0.51), respectively. For these same respective interval comparisons, disease-specific survival was not influenced by the consult-to-admission wait (hazard ratio [HR] 1.0, 95% CI 0.9-1.2, p = 0.91) or the test-to-admission wait (HR 1.0, 95% CI 0.8-1.1, p = 0.63). The risk of death was slightly greater if the consult-to-admission interval was 22 or more days versus 1-7 days (HR 1.1, 95% CI 1.0-1.2, p = 0.013) and if the test-to-admission interval was 43 days or more versus 1-14 days (HR 1.2, 95% CI 1.1-1.3, p = 0.003). Conclusion: It is unlikely that delays to nonemergent colon cancer surgery longer than 3 weeks from initial surgical consult or longer than 6 weeks from first diagnostic test negatively impact operative mortality, disease-specific survival or overall survival.
AB - Background: There has been minimal research on the influence of delays for cancer treatments on patient outcomes. We measured the influence of delays to nonemer- gent colon cancer surgery on operative mortality, disease-specific survival and overall survival. Methods: We used the linked Surveillance, Epidemiology and End Results (SEER)- Medicare databases (1993-1996) to identify patients who underwent nonemergent colon cancer surgery. We assessed 2 time intervals: surgeon consult to hospital admission for surgery and first diagnostic test for colon cancer to hospital admission. Follow- up data were available to the end of 2003. We selected the time intervals to create patient groups with clinical relevance and they did not extend past 120 days. Results: We identified 7989 patients who underwent nonemergent colon cancer surgery. Median delays from surgeon consult to admission and from first diagnostic test to admission were 7 and 17 days, respectively. The odds of operative mortality were similar if the consult-to-admission interval was 22 days or more versus 1-7 days (odds ratio [OR] 1.0, 95% confidence interval [CI] 0.6-1.8, p = 0.91) or if the test-to- admission interval was 43 days or more versus 1-14 days (OR 0.8, 95% CI 0.4-1.5, p = 0.51), respectively. For these same respective interval comparisons, disease-specific survival was not influenced by the consult-to-admission wait (hazard ratio [HR] 1.0, 95% CI 0.9-1.2, p = 0.91) or the test-to-admission wait (HR 1.0, 95% CI 0.8-1.1, p = 0.63). The risk of death was slightly greater if the consult-to-admission interval was 22 or more days versus 1-7 days (HR 1.1, 95% CI 1.0-1.2, p = 0.013) and if the test-to-admission interval was 43 days or more versus 1-14 days (HR 1.2, 95% CI 1.1-1.3, p = 0.003). Conclusion: It is unlikely that delays to nonemergent colon cancer surgery longer than 3 weeks from initial surgical consult or longer than 6 weeks from first diagnostic test negatively impact operative mortality, disease-specific survival or overall survival.
UR - http://www.scopus.com/inward/record.url?scp=69049093896&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=69049093896&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:69049093896
SN - 0008-428X
VL - 52
SP - E79-E86
JO - Canadian Journal of Surgery
JF - Canadian Journal of Surgery
IS - 4
ER -