Does delaying curative surgery for colorectal cancer influence long-term disease-free survival? A cohort study

Langenbecks Arch Surg. 2021 Nov;406(7):2383-2390. doi: 10.1007/s00423-021-02251-4. Epub 2021 Jul 11.

Abstract

Background: Surgical wait list time is a major problem in many health-care systems and its influence on survival is unclear. The aim of this study is to assess the impact of wait list time on long-term disease-free survival in patients scheduled for colorectal cancer resection.

Materials and methods: A prospective study was carried out in patients with colorectal cancer scheduled for surgery at a tertiary care center. Wait list time was defined as the time from completion of diagnostic workup to definitive surgery and divided into 2-week intervals from 0 to 6 weeks. The outcome variables were 2-year and 5-year disease-free survival.

Results: A total of 602 patients, 364 (60.5%) male, median age 73 years (range = 71) were defined. The median wait list time was 28 days (range = 99). Two and 5-year disease-free survival rates were 521 (86.5%) and 500 (83.1%) respectively. There were no differences in 2-year or 5-year disease-free survival for the whole cohort or by tumor stage between wait list time intervals except for AJCC stage II tumors which showed a higher 5-year disease-free survival for the 2-4 and 4-6-week wait list time interval (p = 0.021).

Conclusions: Time from diagnosis to definitive surgery up to 6 weeks is not associated with a decrease in 2-year or 5-year disease-free survival (DFS) in AJCC stage I through III colorectal cancer patients. These are important findings in the light of the COVID-19 pandemic and offer a window of opportunity for preoperative optimization and prehabilitation.

Keywords: Colorectal cancer; Survival; Wait list time.

MeSH terms

  • Aged
  • COVID-19*
  • Cohort Studies
  • Colorectal Neoplasms* / surgery
  • Disease-Free Survival
  • Humans
  • Male
  • Pandemics
  • Prospective Studies
  • Retrospective Studies
  • SARS-CoV-2