The impact of wait times on oncological outcome in high-risk patients with endometrial cancer

J Surg Oncol. 2020 Aug;122(2):306-314. doi: 10.1002/jso.25929. Epub 2020 Apr 14.

Abstract

Objective: To evaluate the impact of surgical wait times on outcome of patients with grade 3 endometrial cancer.

Methods: All consecutive patients surgically treated for grade 3 endometrial cancer between 2007 and 2015 were included. Patients were divided into two groups based on the time interval between endometrial biopsy and surgery: wait time from biopsy to surgery ≤12 weeks (84 days) vs more than 12 weeks. Survival analyses were conducted using log-rank tests and Cox proportional hazards models.

Results: A total of 136 patients with grade 3 endometrial cancer were followed for a median of 5.6 years. Fifty-one women (37.5%) waited more than 12 weeks for surgery. Prolonged surgical wait times were not associated with advanced stage at surgery, positive lymph nodes, increased lymphovascular space invasion, and tumor size (P = .8, P = 1.0, P = .2, P = .9, respectively). In multivariable analysis adjusted for clinical and pathological factors, wait times did not significantly affect disease-specific survival (adjusted hazard ratio [HR]: 1.2, 95% confidence interval [CI], 0.6-2.5, P = .6), overall survival (HR: 1.1, 95% CI, 0.6-2.1, P = .7), or progression-free survival (HR: 0.9, 95% CI, 0.5-1.7, P = .8).

Conclusion: Prolonged surgical wait time for poorly differentiated endometrial cancer seemed to have a limited impact on clinical outcomes compared to biological factors.

Keywords: endometrial cancer; high-grade; hysterectomy; oncological outcome; survival; wait time.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Canada
  • Cohort Studies
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / surgery*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Middle Aged
  • Neoplasm Grading
  • Risk Factors
  • Survival Rate
  • Time-to-Treatment / statistics & numerical data*
  • Treatment Outcome