AlHilli MM, et al. - Researchers examined endometrial cancer (EC) cases with definitive primary surgery between 2004 and 2013, to determine patient and facility-specific factors related to time to surgery (TTS) as well as the influence of delay in TTS >6 weeks on overall survival (OS) by tumor histology and stage. Over the study period, an increase in TTS was noted. In early stage type I EC, a negative association of TTS >6 weeks with OS was observed. In view of these findings, it is necessary to implement interventions to reduce TTS in specific stages and settings for EC.

Methods

• Researchers identified the participants from the National Cancer Database (NCDB).
• Based on EC histology, they stratified patients into type I (endometrioid) and type II (non-endometrioid).
• They estimated TTS (number of days from diagnosis to definitive surgery) as well as trends in TTS.
• Using Poisson regression, they investigated factors related to TTS for patients with type I and type II EC, respectively.
• They used Cox regression to evaluate the effect of delay in TTS > 6 weeks on OS by tumor histology and stage.

Results

• Overall 284,499 patients were included, comprising 83% with type I EC and 17% with type II EC.
• For type I and II EC, the median (interquartile range; IQR) TTS was 27 days (10–41) and 26 days (13–40), respectively.
• Over the study period, increased TTS was observed in both groups.
• In Type I EC, patients with early stage (I-II) EC only showed a link between delay in TTS and worse OS.
• In type II EC, they found OS was not significantly influenced by delay in TTS in stage I-III EC, while a paradoxical link between TTS > 6 weeks and improved OS was evident for stage IV EC.