The Impact of Time to Surgery on Prognosis of Stage I-III Colon Cancer Patients: A Retrospective Cohort Study in China

Abstract Objective: The primary aim of this study was to examine the correlation between the time to surgery (TTS) and overall survival(OS)rates in stage I-III colon cancer patients in China. Methods: A retrospective cohort of 1188 consecutive patients with stage I-III CC who underwent radical resection between September 2008 and September 2017 was collected. The time to surgery(TTS) was defined as the interval between diagnosis and surgical intervention. The study primarily concentrated on OS contingent on distinct TTS thresholds (1 to 2 weeks, 3 to 4 weeks, and beyond 4 weeks). Both univariate and multivariate analyses were utilized to evaluate the prognostic implications of TTS. Results: The study incorporated 1188 patients (700 (58.90%) females and 488 (41.10%) males) with a mean age of 58.5 ± 11.88 years. The median (IQR) time to surgery was 10 (7 - 15) days. Patients with a TTS of 1 to 2 weeks had a 5-year overall survival rate of 82% (n = 866), compared to 90% (n = 282) for those with a TTS of 3 to 4 weeks ( p = 0.003). Multivariable Cox-regression analyses indicated that a TTS exceeding 4 weeks bore no association with overall survival, whereas a TTS of 1 to 2 weeks emerged as a significant independent risk factor for decreased overall survival in the entire cohort (hazard ratio (HR), 1.93; 95% confidence interval: 1.28 - 2.62). Conclusions: The optimal timing for definitive resection in colon cancer is situated between 3 and 4 weeks subsequent to the initial diagnosisin China.