Independent correlation seen for surgery within two weeks after diagnosis and worsened survival
FRIDAY, Dec. 23, 2016 (HealthDay News) — For patients diagnosed with endometrial cancer, surgery within the first two weeks of diagnosis is associated with increased risk of mortality, according to a study published online Dec. 8 in the American Journal of Obstetrics & Gynecology.
David I. Shalowitz, M.D., from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues queried the National Cancer Database (2003 to 2012) for incident endometrial cancers. Cancers were classified as low- or high-risk and analyzed separately (140,078 and 68,360 cancers, respectively). The authors calculated the hazard ratios for mortality by interval between diagnosis and surgery.
The researchers found that for low-risk cancers, surgery in the first and second weeks after diagnosis correlated independently with the risk of mortality (hazard ratios, 1.4 and 1.1, respectively). Patients undergoing surgery in the first or second week after diagnosis had significantly higher 30-day postoperative mortality compared to patients treated in the third or fourth week after diagnosis (0.7 versus 0.4 percent; P < 0.001). For high-risk cancers, there was an independent correlation for surgery in the first and second weeks after diagnosis with mortality risk (hazard ratios, 1.5 and 1.2, respectively). Patients undergoing surgery in the first or second versus the third or fourth week after diagnosis had significantly higher 30-day postoperative mortality (2.5 versus 1.0 percent; P < 0.001).
“We suspect that physicians diagnosing endometrial cancer may believe, not unreasonably, that the best thing they can do for those patients is to operate as soon as possible, because if they wait too long the cancer could progress, resulting in a worse outcome,” Shalowitz said in a statement. “But, the results of our study suggest that pre-surgical care and referring patients to a gynecologic oncologist may be more important.”
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