Department of Surgery, Division of General Surgery, Queen's University, 76 Stuart Street, Kingston, ON K7L 2V7, Canada.
Department of Public Health Sciences, Queen's University, Kingston, ON K7L 2V7, Canada.
Curr Oncol. 2022 Aug 20;29(8):5901-5918. doi: 10.3390/curroncol29080466.
Patients with resectable esophageal cancer are recommended to undergo chemoradiotherapy before esophagectomy. A longer time to surgery (TTS) and/or time to consultation (TTC) may be associated with inferior cancer-related outcomes and heightened anxiety. Thoracic cancer surgery centers (TCSCs) oversee esophageal cancer management, but differences in TTC/TTS between centers have not yet been examined. This Ontario population-level study used linked administrative healthcare databases to investigate patients with esophageal cancer between 2013-2018, who underwent neoadjuvant chemoradiotherapy and then surgery. TTC and TTS were time from diagnosis to the first surgical consultation and then to surgery, respectively. Patients were assigned a TCSC based on the location of the surgery. Patient, disease, and diagnosing physician characteristics were investigated. Quantile regression was used to model TTS/TTC at the 50th and 90th percentiles and identify associated factors. The median TTS and TTC were 130 and 29 days, respectively. The adjusted differences between the TCSCs with the longest and shortest median TTS and TTC were 32 and 18 days, respectively. Increasing age was associated with a 16-day longer median TTS. Increasing material deprivation was associated with a 6-day longer median TTC. Significant geographic variability exists in TTS and TTC. Therefore, the investigation of TCSC characteristics is warranted. Shortening wait times may reduce patient anxiety and improve the control of esophageal cancer.
建议可切除食管癌患者在接受食管癌切除术前行放化疗。手术时间（TTS）和/或咨询时间（TTC）较长可能与较差的癌症相关结局和更高的焦虑相关。胸科癌症手术中心（TCSC）负责食管癌的管理，但各中心之间的 TTC/TTS 差异尚未得到检验。这项安大略省的基于人群的研究使用了链接的医疗保健管理数据库，调查了 2013-2018 年间接受新辅助放化疗后再手术的食管癌患者。TTC 和 TTS 分别是从诊断到第一次手术咨询和手术的时间。患者根据手术地点被分配到 TCSC。研究了患者、疾病和诊断医生的特征。使用分位数回归对 TTS/TTC 的第 50 个和第 90 个百分位数进行建模，并确定相关因素。TTS 和 TTC 的中位数分别为 130 天和 29 天。TTS 和 TTC 中位数最长和最短的 TCSC 之间的调整差异分别为 32 天和 18 天。年龄增加与 TTS 中位数延长 16 天有关。物质贫困程度增加与 TTC 中位数延长 6 天有关。TTS 和 TTC 存在显著的地理差异。因此，有必要对 TCSC 特征进行调查。缩短等待时间可能会减轻患者的焦虑并改善食管癌的控制。
