Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Gynecologic Oncology Laboratory, Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, Quebec, Canada.
J Surg Oncol. 2020 Aug;122(2):306-314. doi: 10.1002/jso.25929. Epub 2020 Apr 14.
To evaluate the impact of surgical wait times on outcome of patients with grade 3 endometrial cancer.
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.
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).
Prolonged surgical wait time for poorly differentiated endometrial cancer seemed to have a limited impact on clinical outcomes compared to biological factors.
评估手术等待时间对 3 级子宫内膜癌患者结局的影响。
纳入 2007 年至 2015 年间接受手术治疗的 3 级子宫内膜癌连续患者。根据子宫内膜活检与手术之间的时间间隔，将患者分为两组：活检至手术的等待时间≤12 周（84 天）与超过 12 周。使用对数秩检验和 Cox 比例风险模型进行生存分析。
共 136 例 3 级子宫内膜癌患者的中位随访时间为 5.6 年。51 例（37.5%）女性等待手术的时间超过 12 周。手术等待时间延长与手术时分期较晚、淋巴结阳性、淋巴管血管间隙侵犯增加和肿瘤大小无关（P = .8，P = 1.0，P = .2，P = .9）。在调整临床和病理因素的多变量分析中，等待时间并未显著影响疾病特异性生存（调整后的危险比[HR]：1.2，95%置信区间[CI]：0.6-2.5，P = .6）、总生存（HR：1.1，95% CI：0.6-2.1，P = .7）或无进展生存（HR：0.9，95% CI：0.5-1.7，P = .8）。
与生物因素相比，分化不良的子宫内膜癌手术等待时间延长似乎对临床结局的影响有限。
