Brett Vair1, Alon D Altman2, Gregg Nelson3. 1. Department of Obstetrics and Gynecology, University of Calgary, Calgary AB. 2. Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, University of Manitoba, Winnipeg MB. 3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Calgary, Calgary AB.
Abstract
OBJECTIVE: There is little current evidence to define an appropriate surgical wait time in patients with cancer. The aim of this study was to examine whether increased time to surgery in patients with early-stage lower genital tract cancers resulted in a risk of cancer progression. METHODS: We conducted a population-based retrospective cohort study of women presenting with stage I squamous cell carcinoma of the cervix, vulva, and vagina and undergoing surgical treatment in Calgary, Alberta between 2000 and 2010. Cancer stage and disease characteristics were compared at two time points: the time of initial presentation to the gynaecologic oncology service and the time of surgery. RESULTS: One hundred fifty-six patients met the inclusion criteria. There was progression of cancer stage in 10 cases (6.4%). In keeping with the current wait time targets, time to surgery was categorized as ≤ 28 days (59 patients; 38%) and > 28 days (97 patients; 62%). Progression occurred in seven of the 123 cases of cervical cancer (9%). In all seven cases, time to surgery was > 28 days (P = 0.095). None of the three cases of vaginal cancer had disease progression. Progression occurred in three (10%) of the 30 cases of vulvar cancer. In two of these three cases, time to surgery was > 28 days (P = 0.586). The relative risk for disease progression with prolonged time to surgery for all women in the cohort was 5.5 (95% CI 0.7 to 42.1) (P = 0.091). CONCLUSION: In patients with early squamous cell carcinoma of the lower genital tract, increased time to surgery (> 28 days) is not associated with cancer progression.
OBJECTIVE: There is little current evidence to define an appropriate surgical wait time in patients with cancer. The aim of this study was to examine whether increased time to surgery in patients with early-stage lower genital tract cancers resulted in a risk of cancer progression. METHODS: We conducted a population-based retrospective cohort study of women presenting with stage I squamous cell carcinoma of the cervix, vulva, and vagina and undergoing surgical treatment in Calgary, Alberta between 2000 and 2010. Cancer stage and disease characteristics were compared at two time points: the time of initial presentation to the gynaecologic oncology service and the time of surgery. RESULTS: One hundred fifty-six patients met the inclusion criteria. There was progression of cancer stage in 10 cases (6.4%). In keeping with the current wait time targets, time to surgery was categorized as ≤ 28 days (59 patients; 38%) and > 28 days (97 patients; 62%). Progression occurred in seven of the 123 cases of cervical cancer (9%). In all seven cases, time to surgery was > 28 days (P = 0.095). None of the three cases of vaginal cancer had disease progression. Progression occurred in three (10%) of the 30 cases of vulvar cancer. In two of these three cases, time to surgery was > 28 days (P = 0.586). The relative risk for disease progression with prolonged time to surgery for all women in the cohort was 5.5 (95% CI 0.7 to 42.1) (P = 0.091). CONCLUSION: In patients with early squamous cell carcinoma of the lower genital tract, increased time to surgery (> 28 days) is not associated with cancer progression.
Entities:
Keywords:
cancer of the uterine cervix; cancer of the vagina; cancer of the vulva; disease progression; surgery
Authors: Amanda N Fader; Warner K Huh; Joshua Kesterson; Bhavana Pothuri; Stephanie Wethington; Jason D Wright; Jamie N Bakkum-Gamez; Pamela T Soliman; Abdulrahman K Sinno; Mario Leitao; Martin A Martino; Amer Karam; Emma Rossi; Jubilee Brown; Stephanie Blank; William Burke; Barbara Goff; S Diane Yamada; Shitanshu Uppal; Sean C Dowdy Journal: Gynecol Oncol Date: 2020-06-06 Impact factor: 5.482
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