The impact of preoperative waiting time in Stage II–III gastric or gastroesophageal junction cancer: A population‐based cohort study
Abstract Background Gastrectomy 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). Methods...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-08-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6320 |
| _version_ | 1797242704268099584 |
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| author | Chih‐Chieh Yen Yi‐Hsin Yang Hsiu‐Ying Ku Huang‐Ming Hu Su‐Shun Lo Hung‐Chi Chang Yee Chao Jen‐Shi Chen Hsiu‐Po Wang Tsang‐En Wang Li‐Yuan Bai Ming‐Shiang Wu Chia‐Jui Yen Li‐Tzong Chen Yan‐Shen Shan |
| author_facet | Chih‐Chieh Yen Yi‐Hsin Yang Hsiu‐Ying Ku Huang‐Ming Hu Su‐Shun Lo Hung‐Chi Chang Yee Chao Jen‐Shi Chen Hsiu‐Po Wang Tsang‐En Wang Li‐Yuan Bai Ming‐Shiang Wu Chia‐Jui Yen Li‐Tzong Chen Yan‐Shen Shan |
| author_sort | Chih‐Chieh Yen |
| collection | DOAJ |
| description | Abstract Background Gastrectomy 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). Methods We 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. Results A 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). Conclusions The 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. |
| first_indexed | 2024-03-12T00:55:26Z |
| format | Article |
| id | doaj.art-afd010633a3f46fc98458e76aa241873 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-24T18:43:27Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-afd010633a3f46fc98458e76aa2418732024-03-27T09:11:00ZengWileyCancer Medicine2045-76342023-08-011216169061691710.1002/cam4.6320The impact of preoperative waiting time in Stage II–III gastric or gastroesophageal junction cancer: A population‐based cohort studyChih‐Chieh Yen0Yi‐Hsin Yang1Hsiu‐Ying Ku2Huang‐Ming Hu3Su‐Shun Lo4Hung‐Chi Chang5Yee Chao6Jen‐Shi Chen7Hsiu‐Po Wang8Tsang‐En Wang9Li‐Yuan Bai10Ming‐Shiang Wu11Chia‐Jui Yen12Li‐Tzong Chen13Yan‐Shen Shan14Institute of Clinical Medicine, School of Medicine National Cheng Kung University Tainan TaiwanNational Institute of Cancer Research, National Health Research Institutes Tainan TaiwanNational Institute of Cancer Research, National Health Research Institutes Tainan TaiwanDepartment of Internal Medicine Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung TaiwanDepartment of Surgery National Yang Ming Chiao Tung University Hospital Yilan TaiwanDepartment of Surgery Chang‐Hua Christian Hospital Changhua TaiwanDepartment of Oncology, School of Medicine, Taipei Veterans General Hospital National Yang Ming Chiao Tung University Taipei TaiwanDepartment of Hematology‐Oncology Linkou Chang Gung Memorial Hospital and Chang Gung University Linkou TaiwanDepartment of Internal Medicine National Taiwan University College of Medicine and Hospital Taipei TaiwanDepartment of Internal Medicine Mackay Memorial Hospital Taipei TaiwanDivision of Hematology and Oncology, Department of Internal Medicine China Medical University Hospital, and China Medical University Taichung TaiwanDepartment of Internal Medicine National Taiwan University College of Medicine and Hospital Taipei TaiwanInstitute of Clinical Medicine, School of Medicine National Cheng Kung University Tainan TaiwanNational Institute of Cancer Research, National Health Research Institutes Tainan TaiwanDepartment of Oncology National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University Tainan TaiwanAbstract Background Gastrectomy 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). Methods We 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. Results A 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). Conclusions The 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.https://doi.org/10.1002/cam4.6320gastric cancergastroesophageal junction cancerpreoperative waiting time |
| spellingShingle | Chih‐Chieh Yen Yi‐Hsin Yang Hsiu‐Ying Ku Huang‐Ming Hu Su‐Shun Lo Hung‐Chi Chang Yee Chao Jen‐Shi Chen Hsiu‐Po Wang Tsang‐En Wang Li‐Yuan Bai Ming‐Shiang Wu Chia‐Jui Yen Li‐Tzong Chen Yan‐Shen Shan The impact of preoperative waiting time in Stage II–III gastric or gastroesophageal junction cancer: A population‐based cohort study Cancer Medicine gastric cancer gastroesophageal junction cancer preoperative waiting time |
| title | The impact of preoperative waiting time in Stage II–III gastric or gastroesophageal junction cancer: A population‐based cohort study |
| title_full | The impact of preoperative waiting time in Stage II–III gastric or gastroesophageal junction cancer: A population‐based cohort study |
| title_fullStr | The impact of preoperative waiting time in Stage II–III gastric or gastroesophageal junction cancer: A population‐based cohort study |
| title_full_unstemmed | The impact of preoperative waiting time in Stage II–III gastric or gastroesophageal junction cancer: A population‐based cohort study |
| title_short | The impact of preoperative waiting time in Stage II–III gastric or gastroesophageal junction cancer: A population‐based cohort study |
| title_sort | impact of preoperative waiting time in stage ii iii gastric or gastroesophageal junction cancer a population based cohort study |
| topic | gastric cancer gastroesophageal junction cancer preoperative waiting time |
| url | https://doi.org/10.1002/cam4.6320 |
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