Delay of Treatment Initiation Does Not Adversely Affect Survival Outcome in Breast Cancer
0
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose Previous studies examining the relationship between time to treatment and survival outcome in breast cancer have shown inconsistent results. The aim of this study was to analyze the overall impact of delay of treatment initiation on patient survival and to determine whether certain subgroups require more prompt initiation of treatment. Materials and Methods This study is a retrospective analysis of stage I-III patients who were treated in a single tertiary institution between 2005 and 2008. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to evaluate the impact of interval between diagnosis and treatment initiation in breast cancer and various subgroups. Results A total of 1,702 patients were included. Factors associated with longer delay of treatment initiation were diagnosis at another hospital, medical comorbidities, and procedures performed before admission for surgery. An interval between diagnosis and treatment initiation as a continuous variable or with a cutoff value of 15, 30, 45, and 60 days had no impact on disease-free survival (DFS). Subgroup analyses for hormone-responsiveness, triple-negative breast cancer, young age, clinical stage, and type of initial treatment showed no significant association between longer delay of treatment initiation and DFS. Conclusion Our results show that an interval between diagnosis and treatment initiation of 60 days or shorter does not appear to adversely affect DFS in breast cancer.
Abstract
Purpose Previous studies examining the relationship between time to treatment and survival outcome in breast cancer have shown inconsistent results. The aim of this study was to analyze the overall impact of delay of treatment initiation on patient survival and to determine whether certain subgroups require more prompt initiation of treatment. Materials and Methods This study is a retrospective analysis of stage I-III patients who were treated in a single tertiary institution between 2005 and 2008. Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to evaluate the impact of interval between diagnosis and treatment initiation in breast cancer and various subgroups. Results A total of 1,702 patients were included. Factors associated with longer delay of treatment initiation were diagnosis at another hospital, medical comorbidities, and procedures performed before admission for surgery. An interval between diagnosis and treatment initiation as a continuous variable or with a cutoff value of 15, 30, 45, and 60 days had no impact on disease-free survival (DFS). Subgroup analyses for hormone-responsiveness, triple-negative breast cancer, young age, clinical stage, and type of initial treatment showed no significant association between longer delay of treatment initiation and DFS. Conclusion Our results show that an interval between diagnosis and treatment initiation of 60 days or shorter does not appear to adversely affect DFS in breast cancer.
참고문헌 (14)
- Brazda A, "Delays in time to treatment and survival impact in breast cancer", Ann Surg Oncol, 17(Suppl 3), pp.291~296 (2010)
- McLaughlin JM, "Effect on survival of longer intervals between confirmed diagnosis and treatment initiation among low-income women with breast cancer", J Clin Oncol, 30, pp.4493~4500 (2012)
- Mujar M, "Delays in time to primary treatment after a diagnosis of breast cancer : does it impact survival?", Prev Med, 56, pp.222~224 (2013)
- Shin DW, "Delay to curative surgery greater than 12 weeks is associated with increased mortality in patients with colorectal and breast cancer but not lung or thyroid cancer", Ann Surg Oncol, 20, pp.2468~2476 (2013)
- Smith EC, "Delay in surgical treatment and survival after breast cancer diagnosis in young women by race", ethnicity, 2013, pp.148, 516~523
- Yun YH, "The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgery", Ann Oncol, 23, pp.2731~2737 (2012)
- Ganz PA, "Quality of life across the continuum of breast cancer care", Breast J, 6, pp.324~330 (2000)
- Eastman A, "Outcomes of delays in time to treatment in triple negative breast cancer", Ann Surg Oncol, 20, pp.1880~1885 (2013)
- Birkmeyer JD, "Regionalization of high-risk surgery and implications for patient travel times", JAMA, 290, pp.2703~2708 (2003)
- Simunovic M, "Using administrative databases to measure waiting times for patients undergoing major cancer surgery in Ontario, 1993-2000", Can J Surg, 48, pp.137~142 (2005)
- Stitzenberg KB, "Centralization of cancer surgery : implications for patient access to optimal care", J Clin Oncol, 27, pp.4671~4678 (2009)
- Bardell T, "Waiting times for cancer surgery in Ontario : 1984-2000", Clin Oncol(R Coll Radiol), 18, pp.401~409 (2006)
- Bilimoria KY, "Wait times for cancer surgery in the United States : trends and predictors of delays", Ann Surg, 253, pp.779~785 (2011)
- Kawakami J, "Measurement of surgical wait times in a universal health care system", Can Urol Assoc J, 2, pp.597~603 (2008)