The Impact of Delay From Diagnosis to Surgeryin Endometrial Cancer

Abstract

Abstract Purpose When oncological waiting lists are prolonged, gynecological-oncology units are forced to delay operations, especially for endometrial cancer (EC) due to its good prognosis among gynecological cancers. The aim of this study is to evaluate the impact of delay in the oncological outcomes of these patients. Methods Retrospective analysis of all women with EC treated in our clinic, 2012–2019. Delay was calculated as the time interval between histological diagnosis of endometrial biopsy and definite surgery. The cut-off point was set at 8 weeks. Patients’ characteristics, treatment options and follow-up information were collected. Primary outcomes were the need of adjuvant treatment and survival rates. Results 259 patients met the inclusion criteria. Based on the 8-week cutoff point patients were divided into two groups: 119 underwent surgery up to 8-weeks (group A) and 140 over 8-weeks (group B). There was no statistical difference in the FIGO stage or the pre-operative CA125 level between the two groups. However, patients in group A were younger, with lower BMI and less comorbidities. Furthermore, patients in group B had a significantly higher probability of receiving pelvic radiation with or without brachytherapy (p = 0.0053). Concerning survival rates, there was a statistically difference in disease-free (p = 0.0312), but no difference was found in overall survival (p = 0.146). Conclusion Delaying EC surgery over 8 weeks may not have an impact on the mortality of the patients, but increases the need of adjuvant pelvic radiation and worsens recurrence rates. As a result, patients experience more side effects which subsequently had negative impact on their quality of life.