Association between delayed surgery and survival in early-stage cervical
cancer in mainland China: Implications during the coronavirus pandemic
Abstract
Objective The COVID-19 pandemic has had a significant impact on
oncogynecologic patients worldwide, particularly with respect to delayed
diagnosis and treatment. During the COVID-19 pandemic, few studies have
examined the impact of delayed surgery on survival in early-stage
cervical cancer patients. The purpose of this study was to determine the
effect of delayed surgical time on survival in patients with early
cervical cancer. Design A retrospective cohort study. Setting A single
general hospital in Shaanxi, Northwest China. Population A total of
1207women with early cervical cancer were recruited between April 2013
and December 2018 in Mainland China and followed up until 29 Feb 2022.
Methods This retrospective cohort study was conducted in a comprehensive
tertiary hospital in Shaanxi, Xi’an, China. We used a Cox proportional
hazard model with delay time in weeks as a categorical variable to
analyse the effect of surgical delay time on survival. Main Outcome
Measures The 5-year overall and disease-free survival were used as the
primary outcome measures. Results A total of 800 participants were
included in the final cohort. In the multivariate Cox regression
analysis (median follow-up, 58 months), patients in the long delay time
group had DFS (5-year rates, 91.5% versus 90.9%, HR 0.99, 95% CI
0.62~1.59, P=0.98) and OS (5-year rates of 92.9% versus
90.8%, HR 0.68, 95% CI 0.42~1.10, P=0.11) similar to
those in the short delay time group. Conclusions Our findings indicate
that a 12-week delay in surgery is not associated with long-term
survival in women with early-stage cervical cancer.