Timing of Uterine Cancer Surgery May Affect Survival

Endometrial cancer surgery wait times may impact overall survival

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) It stands to reason that the longer cancer remains in the body, the greater the chances it will grow and maybe spread. This is known to be the case for some cancers, but remains unclear for others.

Canadian researchers discovered, in a first of its kind study, that wait times between uterine cancer diagnosis and surgery impacted overall survival.

Women who had surgery two to six weeks after their uterine cancer diagnosis had the highest five-year survival rates, this study found.

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Lorraine Elit, MD, MSc, FRCS, led colleagues from the Escarpment Cancer Research Institute at McMaster University in Hamilton, Ontario, Canada in this evaluation of how wait times between the diagnosis of uterine cancer and definitive surgery impacted overall survival.

Previous research has shown that longer wait times negatively impact survival in breast, rectal and bladder cancers, as well as melanoma, the most serious form of skin cancer.

This study is the first to measure wait times as a factor in uterine cancer survival rates.

Uterine and endometrial cancer are the same disease that’s diagnosed in about 50,000 American women each year. Cancer starts in the lining of the uterus called the endometrium, which is why the terms uterine and endometrial cancer are used interchangeably.

Surgery to remove the uterus — a hysterectomy — is the standard treatment for uterine cancer.

For this study, Dr. Elit’s team reviewed information on 9,417 women who had received a hysterectomy for uterine cancer in Ontario, Canada between April 1, 2000 and March 31, 2009. The average age of the women was 62. The researchers relied on a number of databases to track the outcomes of these women.

These researchers were looking at overall survival, which is defined as death from any cause.

Dr. Elit and colleagues looked at the five-year overall survival rates of various wait times — the time of uterine cancer diagnosis until surgery:

  • The five-year survival rate for all the women in the study was 78.7 percent.
  • 71 percent of the women who had wait times of two weeks or less were alive five years after surgery.
  • 82 percent of those with wait times of two to six weeks were still alive at five years.
  • 79.5 percent of the women who waited six weeks to 12 weeks survived five years.
  • 72 percent of the women whose wait times were more than 12 weeks were alive five years after surgery.

“Our results show that women who had surgery within 2 weeks of diagnosis and those with longer wait times from a biopsy diagnosis of uterine cancer to hysterectomy were associated with worse overall survival, even after controlling for other patient, tumor, and structural factors,” the researchers wrote.

The authors added, “Although a causal relationship between wait times and improved survival cannot be established, these results suggest that a reduction in wait times from diagnosis to surgery could potentially reduce mortality from this disease.”

This study was published January 1 in the Journal of Clinical Oncology.

The research was funded by the Institute for Clinical Evaluative Sciences (ICES) and Cancer Care Ontario, the Ministry of Health and Long-Term Care and the Ontario Institute for Cancer Research.

No conflicts of interest were disclosed.

Review Date: 
January 3, 2014
Last Updated:
January 5, 2014