Do Patient Delay and Diagnostic Delay Influence Long Term Survival in Patients with Gastric Cancer?

Abstract

Background and Aims: Gastric cancer is one of the most common malignancies, with an aggressive evolution and a poor long-term prognosis. No screening program is available in Europe for this pathology; therefore, the delay from the appearance of the first symptom until the initiation of treatment might influence the prognosis of gastric cancer patients. We aimed to investigate the impact on the prognosis of the delay in the presentation and diagnosis in patients with gastric adenocarcinoma.
 Methods: Our study is a retrospective, single-center, observational cohort study, based on patients diagnosed with gastric adenocarcinoma and operated in our institution between 2013 and 2021. We have defined patient delay as the time from the onset of symptoms to the first encounter with a health care provider and diagnosis delay as the time from the first consultation with a health care provider to the establishment of the final diagnosis.
 Results: A total of 671 patients were included in our study. The survival rate at 5 years was 55% for the patients operated with curative intent and 7.4% for the patients operated with palliative intent. Patient delay and diagnosis delay were not correlated with the overall survival. A lower survival was observed for patients admitted through transfer (p<0.001) or the emergency department (p<0.001). No statistically significant relationship was identified between patient delay or diagnosis delay and the age, gender or area of origin of patients. Patients that experienced melena or hematemesis had a shorter patient delay, with a highly significant statistical relationship (p<0.01). Patients that experienced nausea, epigastric pain, palpable epigastric tumor mass or anorexia also had a highly significant statistical relationship between the symptoms and the patient delay interval.
 Conclusions: The overall survival is not influenced by the patient delay or diagnosis delay. An earlier presentation was correlated with some specific exhibited symptoms: upper gastro-intestinal bleeding, abdominal pain, palpable epigastric tumor, nausea.

High Expression of THY1 in Intestinal Gastric Cancer as a Key Factor in Tumor Biology: A Poor Prognosis-Independent Marker Related to the Epithelial–Mesenchymal Transition Profile

“…Gastric cancer (GC) is a complex and aggressive disease that currently ranks fifth in incidence and fourth as the leading cause of cancer-related death worldwide [1]. Most cases of GC are diagnosed late, mainly due to their nonspecific symptomatology, contributing to the severity of the disease at diagnosis [2,3]. Thus, despite several advances regarding anticancer therapy in recent years, the prognosis of GC remains unsatisfactory, with a 5-year survival rate of approximately 20%, high recurrence rates, and distal metastasis events [4].…”

Oral health literacy and patient delays among patients receiving endodontic treatment in stomatological hospitals: a correlation study

“…Several studies have shown that patient delays account for a large proportion of the total delay time and can have a more pronounced impact on their prognoses [13,14]. At the same time, patient delays are in uenced by patient characteristics, particularly health-seeking behaviours or beliefs [15,16].…”