Impact of surgical wait times on oncologic outcomes in resectable pancreas adenocarcinoma
| Autor: | Jennifer Li, Charles H. Scudamore, Peter Tw Kim, Sameer Desai, Elizaveta Vasilyeva, Stephen W. Chung, Maja Segedi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Surgical resection
Selection bias medicine.medical_specialty Pancreas adenocarcinoma Multivariate statistics Hepatology business.industry media_common.quotation_subject Gastroenterology Retrospective cohort study 030230 surgery Wait time Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Cox proportional hazards regression medicine In patient business media_common |
| Zdroj: | HPB. 22:892-899 |
| ISSN: | 1365-182X |
| Popis: | Background Timely surgical resection in patients with suspected or diagnosed pancreas adenocarcinoma is an essential part of care. We hypothesized that longer surgical wait time was associated with worse oncologic outcomes. Methods A retrospective cohort of patients (N = 144) with resectable pancreas adenocarcinoma was divided into four wait time groups ( 12 weeks), defined from the time of diagnosis on cross-sectional imaging. Overall and recurrence-free survival were analyzed using the Kaplan–Meier method and Cox proportional hazards regression. A higher rate of conversion to palliative bypass in patients waiting over 4 weeks was observed and further analyzed using post-hoc multivariate regression. Results On multivariable analysis, longer wait time was associated with improved overall (HR 0.49, 95% CI: 0.28–0.85) and recurrence-free survival (HR 0.29, 95% CI: 0.15–0.56) in >12 weeks compared to Conclusion Wait time over 8 weeks was associated with a higher rate of palliative bypass. There was an improvement in overall and recurrence-free survival in patients who waited over 12 weeks, likely due to selection bias. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|