Curtis NJ, et al. - Authors aspired to evaluate if the time from diagnosis to laparoscopic curative surgery was associated with short- and long-term outcomes in the case of colorectal cancer. Results disclosed that the risk factors for longer time to surgery were males, age ≤ 65, higher ASA scores, stoma formation and neoadjuvant treatment. It was noted the overall survival was not affected by the time from colorectal cancer diagnosis to curative laparoscopic surgery. Yielded data could permit preoperative pathway alteration without compromising safety.

Methods

• Using a dedicated, prospectively populated database, researchers carried out an exploratory analysis.
• Biopsy-proven colorectal adenocarcinoma undergoing elective laparoscopic surgery with curative intent served as the inclusion criteria.
• Data was extracted with regard to demographics, date of diagnosis and surgery from subjects dichotomised using 4-, 8- and 12-week time points.
• The follow-up in a standardised pathway was 5 years for all participants.
• Through Kaplan-Meier log-rank method, the overall survival was evaluated.

Results

• A total of 668 consecutive patients were selected.
• It was found that the mean time from diagnosis to surgery was 53 days (95% CI 48.3-57.8).
• Males (OR 1.92 [1.2-3.1], p=0.008), age ≤ 65 (OR 1.9 [1.2-3], p=0.01), higher ASA scores (p=0.01) stoma formation (OR 6.9 [4.1-11], p < 0.001) and neoadjuvant treatment (OR 5.06 [3.1-8.3], p < 0.001) were discovered to be the risk factors for longer time to surgery.
• No tie-up was reported between time to surgery and BMI (p=0.36), conversion (16.3%, p=0.5), length of stay (p=0.33) and readmission or reoperation (p=0.3).
• In five-year survival, there were no variations in those operated within 4, 8 and 12 weeks (p=0.397, p=0.962 and p=0.611, respectively).
• No correlation was identified between time from diagnosis to surgery with five-year overall survival (HR 0.99, p=0.52) in the multivariate analysis.