Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Ann Surg Oncol. 2010 Oct;17 Suppl 3:291-6. doi: 10.1245/s10434-010-1250-6. Epub 2010 Sep 19.
Time interval from diagnosis of breast cancer to treatment has been promulgated as one factor that can be used to evaluate cancer care quality. It remains controversial, however, whether a delay to treatment impacts survival. The purpose of this study was to evaluate whether delays from diagnosis to initial treatment in breast cancer impacts survival.
A retrospective review of patients undergoing breast cancer treatment between August 2005 and December 2008 in a comprehensive, multidisciplinary breast oncology program was undertaken. Two hospital systems were included: a county hospital (CH) treating a primarily minority, indigent population and a university hospital (UH) treating a primarily Caucasian, insured population. Interval to treatment, calculated from date of diagnosis to surgery, chemotherapy, or radiation treatment, and overall survival was compared between the two groups.
A total of 1337 patients were included; 634 patients were treated in the CH and 703 in the UH. Interval to treatment was longer in the CH compared with the UH (53.4 ± 2.0 vs 33.2 ± 1.2 days; mean ± standard error of the mean [SEM], P < .0001). Patients treated at the CH had overall worse survival (P = .02); however, this difference did not hold true when controlled for stage. Additionally, when time to treatment was analyzed as an individual variable for all patients, there was no impact on survival.
Interval from diagnosis to treatment of breast cancer within the same cancer center was longer at the CH than the UH. There was, however, no effect on overall survival. Time to treatment may not be a meaningful indicator of cancer care quality.
从乳腺癌诊断到治疗的时间间隔已被公布为评估癌症护理质量的一个因素。然而，治疗是否延迟会影响生存仍然存在争议。本研究的目的是评估乳腺癌诊断后至初始治疗的延迟是否会影响生存。
对 2005 年 8 月至 2008 年 12 月期间在一个综合性多学科乳腺癌肿瘤学项目中接受乳腺癌治疗的患者进行了回顾性研究。纳入了两个医院系统：一个是县医院（CH），主要治疗少数民族贫困人群；另一个是大学医院（UH），主要治疗白人保险人群。在这两个组之间比较了从诊断到手术、化疗或放疗的治疗间隔和总生存率。
共纳入 1337 例患者；634 例患者在 CH 治疗，703 例患者在 UH 治疗。与 UH 相比，CH 的治疗间隔时间更长（53.4±2.0 与 33.2±1.2 天；均数±标准误 [SEM]，P<.0001）。在 CH 治疗的患者总体生存率较差（P=.02）；然而，当控制分期时，这种差异并不成立。此外，当将所有患者的治疗时间作为单个变量进行分析时，对生存没有影响。
在同一癌症中心，从乳腺癌诊断到治疗的时间间隔在 CH 比 UH 更长。然而，这对总生存率没有影响。治疗时间可能不是癌症护理质量的有意义指标。
