Association between delayed surgery and survival in early-stage cervical cancer in mainland China: Implications during the coronavirus pandemic (preprint)

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.