Time to Surgery for Patients with Esophageal Cancer Undergoing Trimodal Therapy in Ontario: A Population-Based Cross-Sectional Study
Patients with resectable esophageal cancer are recommended to undergo chemoradiotherapy before esophagectomy. A longer time to surgery (TTS) and/or time to consultation (TTC) may be associated with inferior cancer-related outcomes and heightened anxiety. Thoracic cancer surgery centers (TCSCs) overs...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/29/8/466 |
| _version_ | 1797446182288490496 |
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| author | Nader M. Hanna Paul Nguyen Wiley Chung Patti A. Groome |
| author_facet | Nader M. Hanna Paul Nguyen Wiley Chung Patti A. Groome |
| author_sort | Nader M. Hanna |
| collection | DOAJ |
| description | Patients with resectable esophageal cancer are recommended to undergo chemoradiotherapy before esophagectomy. A longer time to surgery (TTS) and/or time to consultation (TTC) may be associated with inferior cancer-related outcomes and heightened anxiety. Thoracic cancer surgery centers (TCSCs) oversee esophageal cancer management, but differences in TTC/TTS between centers have not yet been examined. This Ontario population-level study used linked administrative healthcare databases to investigate patients with esophageal cancer between 2013–2018, who underwent neoadjuvant chemoradiotherapy and then surgery. TTC and TTS were time from diagnosis to the first surgical consultation and then to surgery, respectively. Patients were assigned a TCSC based on the location of the surgery. Patient, disease, and diagnosing physician characteristics were investigated. Quantile regression was used to model TTS/TTC at the 50th and 90th percentiles and identify associated factors. The median TTS and TTC were 130 and 29 days, respectively. The adjusted differences between the TCSCs with the longest and shortest median TTS and TTC were 32 and 18 days, respectively. Increasing age was associated with a 16-day longer median TTS. Increasing material deprivation was associated with a 6-day longer median TTC. Significant geographic variability exists in TTS and TTC. Therefore, the investigation of TCSC characteristics is warranted. Shortening wait times may reduce patient anxiety and improve the control of esophageal cancer. |
| first_indexed | 2024-03-09T13:36:34Z |
| format | Article |
| id | doaj.art-ee6e589015be469d8b1bab3de288fc52 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T13:36:34Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-ee6e589015be469d8b1bab3de288fc522023-11-30T21:11:50ZengMDPI AGCurrent Oncology1198-00521718-77292022-08-012985901591810.3390/curroncol29080466Time to Surgery for Patients with Esophageal Cancer Undergoing Trimodal Therapy in Ontario: A Population-Based Cross-Sectional StudyNader M. Hanna0Paul Nguyen1Wiley Chung2Patti A. Groome3Department of Surgery, Division of General Surgery, Queen’s University, 76 Stuart Street, Kingston, ON K7L 2V7, CanadaICES Queen’s, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Surgery, Division of Thoracic Surgery, Queen’s University, Kingston, ON K7L 2V7, CanadaDepartment of Public Health Sciences, Queen’s University, Kingston, ON K7L 2V7, CanadaPatients with resectable esophageal cancer are recommended to undergo chemoradiotherapy before esophagectomy. A longer time to surgery (TTS) and/or time to consultation (TTC) may be associated with inferior cancer-related outcomes and heightened anxiety. Thoracic cancer surgery centers (TCSCs) oversee esophageal cancer management, but differences in TTC/TTS between centers have not yet been examined. This Ontario population-level study used linked administrative healthcare databases to investigate patients with esophageal cancer between 2013–2018, who underwent neoadjuvant chemoradiotherapy and then surgery. TTC and TTS were time from diagnosis to the first surgical consultation and then to surgery, respectively. Patients were assigned a TCSC based on the location of the surgery. Patient, disease, and diagnosing physician characteristics were investigated. Quantile regression was used to model TTS/TTC at the 50th and 90th percentiles and identify associated factors. The median TTS and TTC were 130 and 29 days, respectively. The adjusted differences between the TCSCs with the longest and shortest median TTS and TTC were 32 and 18 days, respectively. Increasing age was associated with a 16-day longer median TTS. Increasing material deprivation was associated with a 6-day longer median TTC. Significant geographic variability exists in TTS and TTC. Therefore, the investigation of TCSC characteristics is warranted. Shortening wait times may reduce patient anxiety and improve the control of esophageal cancer.https://www.mdpi.com/1718-7729/29/8/466esophageal cancertime to surgeryepidemiologygeographical variabilitytreatment interval |
| spellingShingle | Nader M. Hanna Paul Nguyen Wiley Chung Patti A. Groome Time to Surgery for Patients with Esophageal Cancer Undergoing Trimodal Therapy in Ontario: A Population-Based Cross-Sectional Study Current Oncology esophageal cancer time to surgery epidemiology geographical variability treatment interval |
| title | Time to Surgery for Patients with Esophageal Cancer Undergoing Trimodal Therapy in Ontario: A Population-Based Cross-Sectional Study |
| title_full | Time to Surgery for Patients with Esophageal Cancer Undergoing Trimodal Therapy in Ontario: A Population-Based Cross-Sectional Study |
| title_fullStr | Time to Surgery for Patients with Esophageal Cancer Undergoing Trimodal Therapy in Ontario: A Population-Based Cross-Sectional Study |
| title_full_unstemmed | Time to Surgery for Patients with Esophageal Cancer Undergoing Trimodal Therapy in Ontario: A Population-Based Cross-Sectional Study |
| title_short | Time to Surgery for Patients with Esophageal Cancer Undergoing Trimodal Therapy in Ontario: A Population-Based Cross-Sectional Study |
| title_sort | time to surgery for patients with esophageal cancer undergoing trimodal therapy in ontario a population based cross sectional study |
| topic | esophageal cancer time to surgery epidemiology geographical variability treatment interval |
| url | https://www.mdpi.com/1718-7729/29/8/466 |
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