The impact of time to surgery on oncological outcomes in stage I-III dMMR colon cancer - A nationwide cohort study
Menée à partir de données danoises portant sur 4 130 patients atteints d'un cancer du côlon de stade I-III avec déficience du système de réparation des mésappariements de l'ADN (âge moyen : 73,8 ans ; durée médiane de suivi : 43,9 mois), cette étude analyse l'effet, sur la survie globale et la survie sans maladie, du délai entre le diagnostic et l'intervention chirurgicale
Introduction: One of the considerations when investigating neoadjuvant interventions is the prolonging of time from diagnosis to curative surgery (i.e. the treatment interval [TI]). The aim of this study was to investigate the association between the length of TI and overall survival and disease-free survival in patients with deficient mismatch repair (dMMR) colon cancer. Materials and methods: This retrospective propensity score-adjusted study included all patients of ≥18 years of age undergoing elective curative surgery for stage I-III, dMMR colon cancer. Data were extracted from four Danish patient databases. Outcomes were investigated in groups with TIs of ≤14 days versus >14 days. Propensity scores were computed using all demographics, diagnoses and measurements. Matching was done in a 1:1 ratio. Results: A total of 4130 patients were included in the study with a mean age of 73.8 years and a median follow-up time of 43.9 months. After matching, 2794 patients were included in the analysis of overall survival. No significant difference in overall survival was seen between patients with TIs of ≤14 days versus >14 days (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.81–1.17; p = 0.78). In the analysis of disease-free survival, 1798 patients were included after matching. This showed no significant difference between patients with TIs of ≤14 days versus >14 days (HR, 0.85; 95% CI, 0.69–1.06; p = 0.14). Conclusion: No associations were found between TI and overall survival and disease-free survival in patients with stage I-III, dMMR colon cancer undergoing elective curative surgery.