A Diagnosis-to-Surgery Interval Time of >30 Days Does Not Independently Predict Significantly Poorer Survival Outcomes in Thai Patients with Non-metastatic/stage I-III Colorectal Cancer

Kittipat  Visansirikul; Thikhamporn  Tawantanakorn; Varut Lohsiriwat; Thawatchai  Akaraviputh; Vitoon Chinswangwatanakul; Atthaphorn  Trakarnsanga

doi:10.33192/smj.v78i7.280490

Authors

Kittipat Visansirikul Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Thikhamporn Tawantanakorn Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Varut Lohsiriwat Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Thawatchai Akaraviputh Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Vitoon Chinswangwatanakul Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Atthaphorn Trakarnsanga Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v78i7.280490

Keywords:

Diagnosis-to-surgery interval time >30 days, significantly poorer survival outcomes, Thai patients, non-metastatic/stage I-III colorectal cancer

Abstract

Objective: To identify the cutoff value for the optimal number of days to surgery, and to investigate the independent association between the diagnosis-to-surgery interval time (DIT) and survival outcome in Thai patients with nonmetastatic/stage I-III colorectal cancer.

Materials and Methods: A chart review of patients diagnosed with and operated upon for stage non-metastatic/stage I-III colorectal cancer at Siriraj Hospital (Bangkok, Thailand) during January 2010-December 2020 was conducted. The primary outcome was the survival rate compared between two different DITs. Multivariate regression was used to identify independent predictors of decreased survival.

Results: A total of 979 patients (median age: 65 years) were included. Of those, 18.4% had stage I, 38.6% had stage II, and 43.0% had stage III disease. The calculated median DIT of 30 days (IQR: 19-47) was used as the cutoff value to categorize patients into the ≤30-days or >30-days group. The 5-year overall survival rate was 97.6% and 97.1% (p=0.536), and the median survival time was 59.4 and 58.9 months - both respectively. The 3-year disease-free survival (DFS) rate was 86.9% and 85.7%, respectively (p=0.523). The independent predictors of decreased 3-year DFS among all patients were lymph node metastasis (p=0.037), adjuvant chemotherapy (p=0.005), and lymphovascular invasion (p=0.051). Further multivariate analysis in the DIT >30-days group found low preoperative albumin level (p=0.035), perineural invasion (p=0.011), and adjuvant chemotherapy (p<0.001) to independently predict significantly poorer 3-year DFS.

Conclusions: A DIT >30 days was not found to independently predict significantly poorer survival outcomes in Thai patients with non-metastatic/stage I-III colorectal cancer.

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