Cancer Res Treat.  2022 Jan;54(1):245-252. 10.4143/crt.2021.023.

Effect of Waiting Time from Pathological Diagnosis to Definitive Concurrent Chemoradiation for Cervical Cancer on Overall Survival

• Noh KW
• Kim B
• Choi CH
• Kim TJ
• Lee JW
• Kim BG
• Bae DS
• Cho WK
• Park W
• Lee YY

• KMID: 2524605
• DOI: http://doi.org/10.4143/crt.2021.023

Abstract

Purpose
This study aimed to evaluate the effect of waiting time, from diagnosis to initiation of definitive concurrent chemoradiation (CCRT), on overall survival in cervical cancer patients.
Materials and Methods
Patients with cervical cancer who were treated with definitive CCRT between 2000 and 2017 were retrospectively reviewed. Time from initial pathological diagnosis to definitive CCRT was analyzed both as a continuous variable (per day) and as a categorical variable in two groups (group 1 ≤ median, group 2 > median). Patients with a waiting time of more than 60 days were excluded.
Results
The median waiting time was 14 days (0-60). There were differences between group 1 and group 2 in age and chemotherapy regimens. However, no significant difference was found in the International Federation of Gynecology and Obstetrics stage, cell type, or the number of cycles of chemotherapy received during CCRT. A longer waiting time was associated with poorer overall survival on the Kaplan-Meier curve (group 1 vs. group 2, p=0.042). On multivariate analysis, intervals as either a continuous variable (hazard ratio [HR], 1.023; 95% confidence interval [CI], 1.006 to 1.040; p=0.007) or a categorical variable (HR, 1.513; 95% CI, 1.073 to 2.134; p=0.018), FIGO stage, cell type, and the number of cycles of chemotherapy received during CCRT were significant independent prognostic factors for overall survival.
Conclusion
A shorter waiting time from pathological diagnosis to definitive CCRT showed benefit on overall survival. Our findings suggest that an effort to minimize waiting times should be recommended in cervical cancer patients who are candidates for CCRT.

Keyword

Cervical cancer; Concurrent chemoradiation; Waiting time; Overall survival; Multivariate analysis

Figure

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  Fig. 1 Number of patients based on waiting time from pathological diagnosis confirmed on pathologic report to the first day of concurrent chemoradiation.

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  Fig. 2 Kaplan-Meier survival curves for overall survival. Patients were divided into four groups per week of intervals (A) or two groups based on median waiting time (B).

Reference

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