Good Hope Hospital, Heart of England NHS Trust Warley Medical Centre, Kingsway, Oldbury, UK.
Colorectal Dis. 2012 Apr;14(4):e177-80. doi: 10.1111/j.1463-1318.2011.02826.x.
The aim of this study was to compare 5-year survival rates in colorectal cancer (CRC) patients who underwent potentially curative surgery before and after the introduction of the 2-week wait (2WW) referral system.
Data were collected retrospectively from a prospectively maintained cancer database for CRC patients who underwent surgery in 1999 (pre-2WW group, n = 150) and 2002 (post-2WW group, n = 126). Patients who presented as an emergency, those who died within 30 days of surgery and those who presented with incurable CRC were excluded. We used the Kaplan-Meier method to plot survival curves and the log rank test to compare survival rates between the two groups.
The 5-year survival rates in the pre-2WW and post-2WW groups did not differ significantly (71%vs 72%, respectively; P = 0.880). The number of CRC patients who presented via urgent pathways was higher in the post-2WW group than in the pre-2WW group (77%vs 38%, P < 0.001). Further, owing to this change in the referral pattern, the overall delay between referral and treatment was significantly lower in the post-2WW group than in the pre-2WW group (median 76 days vs 115, P = 0.009).
The 2WW referral system for patients with symptoms of CRC does not translate into improved survival. However, more patients with symptomatic CRC are being referred via urgent pathways.
本研究旨在比较结直肠癌（CRC）患者在引入 2 周等待（2WW）转诊系统前后接受潜在治愈性手术的 5 年生存率。
从一个前瞻性维护的 CRC 患者癌症数据库中回顾性收集数据，纳入 1999 年（2WW 前组，n=150）和 2002 年（2WW 后组，n=126）接受手术的患者。排除急诊就诊、术后 30 天内死亡以及诊断为不可治愈 CRC 的患者。我们使用 Kaplan-Meier 方法绘制生存曲线，并使用对数秩检验比较两组的生存率。
2WW 前组和 2WW 后组的 5 年生存率无显著差异（分别为 71%和 72%；P=0.880）。2WW 后组通过紧急途径就诊的 CRC 患者数量明显多于 2WW 前组（77% vs 38%，P<0.001）。此外，由于转诊模式的改变，2WW 后组的转诊和治疗之间的总延迟明显低于 2WW 前组（中位数分别为 76 天和 115 天，P=0.009）。
对于有 CRC 症状的患者的 2WW 转诊系统并未转化为生存率的提高。然而，更多有症状的 CRC 患者通过紧急途径被转诊。
