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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2021.023    [Accepted]
Effect of Waiting Time from Pathological Diagnosis to Definitive Concurrent Chemoradiation (CCRT) for Cervical Cancer on Overall Survival
Kyoung Won Noh1, Bomi Kim1, Chel Hun Choi1, Tae-Joong Kim1, Jeong-Won Lee1, Byoung-Gie Kim1, Duk-Soo Bae1, Won Kyung Cho2, Won Park2, Yoo-Young Lee1
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence  Won Park ,Tel: 82-2-3410-2616, Fax: 82-2-3410-2619, Email: wonro.park@samsung.com
Yoo-Young Lee ,Tel: 82-2-3841-3544, Fax: 82-2-3410-0630, Email: yooyoung.lee@samsung.com
Received: January 7, 2021;  Accepted: April 14, 2021.  Published online: April 15, 2021.
ABSTRACT
Purpose
This study aimed to evaluate the effect of waiting time, from diagnosis to initiation of definitive concurrent chemoradiation (CCRT), on overall survival in cervical cancer patients.
Materials and Methods
Patients with cervical cancer who were treated with definitive CCRT between 2000 and 2017 were retrospectively reviewed. Time from initial pathological diagnosis to definitive CCRT was analyzed both as a continuous variable (per day) and as a categorical variable in 2 groups (Group 1 ≤ median, Group 2 > median). Patients with a waiting time of more than 60 days were excluded.
Results
The median waiting time was 14 days (0-60). There were differences between Group 1 and Group 2 in age and chemotherapy regimens. However, no significant difference was found in the FIGO stage, cell type, or the number of cycles of chemotherapy received during CCRT. A longer waiting time was associated with poorer overall survival on the Kaplan-Meier curve (Group 1 vs. Group 2, p=0.042). On multivariate analysis, intervals as either a continuous variable (HR; 1. 023, 95% CI; 1.006–1.040, p=0.007) or a categorical variable (HR; 1.513, 95% CI; 1.073–2.134, p=0.018), FIGO stage, cell type, and the number of cycles of chemotherapy received during CCRT were significant independent prognostic factors for overall survival.
Conclusion
A shorter waiting time from pathological diagnosis to definitive CCRT showed benefit on overall survival. Our findings suggest that an effort to minimize waiting times should be recommended in cervical cancer patients who are candidates for CCRT.
Key words: Cervical cancer, Concurrent chemoradiation, Waiting time, Overall survival, Multivariate analysis
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