Introduction Patients can be concerned that a delay of several weeks between colon cancer diagnosis and surgery might adversely affect their outcome. We investigated whether the length of time between diagnosis and major resection affected the 2 year all-cause mortality rate for patients with colon cancer.
Method We used data from the National Bowel Cancer Audit to study patients who were diagnosed with colon cancer (excluding rectal cancer) in England between 1 April 2008 and 31 March 2011, who subsequently underwent an elective major resection within 8 weeks of this diagnosis. We derived patient/ tumour characteristics and time to procedure from audit data. Patient survival, mode of admission and co-morbidities were established via data linkage to HES (Hospital Episode Statistics). We calculated the observed and adjusted 2 year mortality rate for two week time bands (<14 days, 14–27 days, 28–41 days, 42–55 days). Our risk adjustment model included year of surgical procedure, patient age, sex, tumour site, tumour stage (TNM), ASA grade, HES mode of hospital admission and patient co-morbidity.
Results 17,854 patients were eligible for analysis: 2,972 (16.6%) died within 2 years of their major resection procedure. The overall observed 2 year mortality rate was 16.2% and was highest in the group of patients who underwent surgery within 14 days of diagnosis (20.1%). Those who underwent surgery within 28 to 41 days had the lowest observed mortality rate (13.8%). This trend in 2 year mortality was reduced but still present after risk adjustment, with the adjusted 2 year mortality rate ranging from 15.4% (28–41 day group) to 17.0% (<14 day group).
Conclusion Patients who underwent surgery within 2 weeks of diagnosis had a higher 2 year all-cause mortality rate than those who underwent surgery between 4 and 6 weeks after diagnosis. These results suggest that the scheduling of colonic cancer surgery for administrative reasons, 4 weeks and more after diagnosis does not appear to adversely affect outcome.
Disclosure of interest None Declared.
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