Association Between Waiting Time from Diagnosis to Treatment and Survival in Patients with Curable Gastric Cancer: A Population-Based Study in the NetherlandsReportar como inadecuado




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Annals of Surgical Oncology

, Volume 24, Issue 7, pp 1761–1769

First Online: 28 March 2017Received: 06 December 2016DOI: 10.1245-s10434-017-5820-8

Cite this article as: Brenkman, H.J.F., Visser, E., van Rossum, P.S.N. et al. Ann Surg Oncol 2017 24: 1761. doi:10.1245-s10434-017-5820-8

Abstract

BackgroundIn the Netherlands, a maximum waiting time from diagnosis to treatment WT of 5 weeks is recommended for curative cancer treatment. This study aimed to evaluate the association between WT and overall survival OS in patients undergoing gastrectomy for cancer.

MethodsThis nationwide study included data from patients diagnosed with curable gastric adenocarcinoma between 2005 and 2014 from the Netherlands Cancer Registry. Patients were divided into two groups: patients who received neoadjuvant therapy followed by gastrectomy, or patients who underwent gastrectomy as primary surgery. WT was analyzed as a categorical ≤5 weeks Reference, 5–8 weeks, >8 weeks and as a discrete variable. Multivariable Cox regression analysis was used to assess the influence of WT on OS.

ResultsAmong 3778 patients, 1701 received neoadjuvant chemotherapy followed by gastrectomy, and 2077 underwent primary gastrectomy. In the neoadjuvant group, median WT to neoadjuvant treatment was 4.6 weeks interquartile range IQR 3.4–6.0, and median OS was 32 months. In the surgery group, median WT to surgery was 6.0 weeks IQR 4.3–8.4, and median OS was 25 months. For both groups, WT did not influence OS neoadjuvant: 5–8 weeks, hazard ratio HR 0.82, p = 0.068; >8 weeks, HR 0.85, p = 0.354; each additional week WT, HR 0.96, p = 0.078; surgery: 5–8 weeks, HR 0.91, p = 0.175; >8 weeks, HR 0.92, p = 0.314; each additional week WT, HR 0.99, p = 0.264.

ConclusionsLonger WT until the start of curative treatment for gastric cancer is not associated with worse OS. These results could help to put WT into perspective as indicator of quality of care and reassure patients with gastric cancer.

H. J. F. Brenkman, E. Visser have contributed equally to this manuscript.

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Autor: H. J. F. Brenkman - E. Visser - P. S. N. van Rossum - S. Siesling - R. van Hillegersberg - J. P. Ruurda

Fuente: https://link.springer.com/







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