Impact of time to surgery on survival in potentially curable colonic cancer – a retrospective analysis of an Australian population-based registry

Purpose: Growing demand for elective surgery has led to increased surgical wait times. Though cancer operations are given priority, delays to surgery still occur. The primary aim of this study was to determine what effect time from diagnosis to surgery had on overall survival in patients undergoing potentially curable bowel resections for colonic cancer. Secondary aims included analysing the effect of time from diagnosis to surgery on inpatient mortality and length of admission. Method : This was a retrospective cohort study using a population-based database that included all patients who were diagnosed with colonic cancer in the state of Queensland, Australia from 2001 to 2021. Patients were divided into five groups depending on number of days from diagnosis to surgery (DDtS): 0-2, 3-30, 31-60, 61-90, >90. Patients included in this study had colonic cancer, underwent major resection, had stage I-III disease, and had upfront surgery. Results : This study included 19 272 patients, out of 56 769 patients in the population based dataset. 0-2 DDtS group had the poorest survival at five years (53.6%; p <.001) while 31-60 DDtS group had the best (71.6%; p <.001) with survival declining in the 61-90 and >90 DDtS groups (68.3% and 62.0%; p <.001). Cox analysis showed similar findings. 0-2 DDtS group had the highest rate of inpatient mortality and longest length of hospital stay. Conclusion : The 0-2 DDtS group had the poorest long-term survival, potentially as a result of more advanced and emergent pathology. Patients with DDtS greater than 60 days had a significant reduction in long term survival.