The impact of preoperative waiting time in Stage II–III gastric or gastroesophageal junction cancer: A population‐based cohort study

Abstract

BackgroundGastrectomy remains the curative option in gastric cancer. However, the growing concern that preoperative waiting jeopardizes survival has not been fully addressed. The present population‐based cohort study aimed to clarify the impact of preoperative waiting time (PreWT).MethodsWe included patients with clinical Stage II–III gastric cancer who received curative surgery from 2008 to 2017 of Taiwan Cancer Registry. PreWT was defined as the time from endoscopic diagnosis to surgery. The prognostic impact on overall survival (OS) was evaluated with Cox and restricted cubic spline regressions.ResultsA total of 3059 patients with a median age of 68 years were evaluated. The median PreWT was 16 days (interquartile range, 11–24 days), and patients with a shorter PreWT were younger, had a more advanced disease and received adjuvant therapies. Despite a shorter OS occurring with prolonged PreWT (median OS by PreWT [days]: 7–13, 2.7 years; 14–20, 3.1 years; 21–27, 3.0 years; 28–34, 4.7 years; 35–31, 3.7 years; 42–48, 3.4 years; 49–118, 2.8 years; p = 0.029), the differences were not significant after adjustment. The Cox and restricted cubic spline regressions showed that prolonged PreWT was not a significant prognostic factor for OS (p = 0.719).ConclusionsThe population‐based study suggests that a PreWT of 49–118 days does not independently correlate with a poor prognosis in Stage II–III gastric cancer. The study provides rationale for a window period for preoperative therapies and patient optimization.

Assessing the Influence of the COVID-19 Pandemic on Gastric Cancer Mortality Risk

“…In addition, previous reports indicate prolonged waiting times from diagnosis to surgery and delays in the initiation of chemotherapy due to the pandemic, and our study did not include an evaluation of these aspects [42]. However, various studies have shown that the wait time between diagnosis and treatment does not affect the prognosis of GC [43][44][45][46]. Although there are concerns about changes in the quality of treatment due to the COVID-19 pandemic, reports in Japan have shown no changes in the postoperative 30-or 90-day mortality rates or in the incidence of postoperative complications such as pneumonia and sepsis [19,47].…”

Prehabilitation in Adults Undergoing Cancer Surgery: A Comprehensive Review on Rationale, Methodology, and Measures of Effectiveness

“…In pancreatic cancer, median waiting time was reported at 31 days but may extend beyond 56 days. Fortunately, waiting times alone do not appear to have a significant effect on survival for pancreatic [106], colorectal [107], gastric [108], and lung cancers [109].…”