Time to diagnosis in esophageal cancer

a cohort study

Francesco Cavallin, Marco Scarpa, Matteo Cagol, Rita Alfieri, Alberto Ruol, Vanna Chiarion Sileni, Massimo Rugge, Ermanno Ancona, Carlo Castoro

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The association between shorter time to diagnosis and favorable outcome is still unproven in esophageal cancer. This study aims to evaluate the effect of time to diagnosis on patient prognosis.

MATERIAL AND METHODS: Retrospective cohort study of all 3613 symptomatic patients referred for esophageal cancer to our center from 1980 to 2011. Time to diagnosis was calculated as the number of days from first symptom onset to the diagnosis of esophageal cancer. The main outcome measures were: resectability and severe malnutrition at diagnosis; postoperative morbidity, mortality and survival.

RESULTS: Longer time to diagnosis was significantly associated with severe malnutrition at diagnosis (odds ratio (OR): 1.003, 95% confidence interval (C.I.).: 1.001-1.006) but not with resectability (OR: 0.997, 95% C.I.: 0.994-1.001). Longer time to diagnosis was not associated with postoperative morbidity (OR: 1.000, 95% C.I.: 0.998-1.003), postoperative mortality (OR: 1.002, 95% C.I.: 0.998-1.006), five-year overall survival (hazard ratio (HR): 0.999, 95% C.I.: 0.997-1.001) or five-year disease free survival (HR: 0.999, 95% C.I.: 0.998-1.001).

CONCLUSION: Longer time to diagnosis did not affect resectability, postoperative morbidity or survival. Further campaigns to raise awareness of cancer among population and primary health care providers may have limited effect on clinical outcome.

Original languageEnglish
Pages (from-to)1179-1184
Number of pages6
JournalActa oncologica
Volume57
Issue number9
DOIs
Publication statusPublished - Sep 2018

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Esophageal Neoplasms
Cohort Studies
Confidence Intervals
Odds Ratio
Morbidity
Malnutrition
Survival
Mortality
Health Personnel
Disease-Free Survival
Primary Health Care
Retrospective Studies
Outcome Assessment (Health Care)

Keywords

  • Adenocarcinoma/diagnosis
  • Aged
  • Carcinoma, Squamous Cell/diagnosis
  • Cohort Studies
  • Delayed Diagnosis/statistics & numerical data
  • Early Diagnosis
  • Esophageal Neoplasms/diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Time Factors

Cite this

Time to diagnosis in esophageal cancer : a cohort study. / Cavallin, Francesco; Scarpa, Marco; Cagol, Matteo; Alfieri, Rita; Ruol, Alberto; Chiarion Sileni, Vanna; Rugge, Massimo; Ancona, Ermanno; Castoro, Carlo.

In: Acta oncologica, Vol. 57, No. 9, 09.2018, p. 1179-1184.

Research output: Contribution to journalArticle

Cavallin, Francesco ; Scarpa, Marco ; Cagol, Matteo ; Alfieri, Rita ; Ruol, Alberto ; Chiarion Sileni, Vanna ; Rugge, Massimo ; Ancona, Ermanno ; Castoro, Carlo. / Time to diagnosis in esophageal cancer : a cohort study. In: Acta oncologica. 2018 ; Vol. 57, No. 9. pp. 1179-1184.
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abstract = "BACKGROUND: The association between shorter time to diagnosis and favorable outcome is still unproven in esophageal cancer. This study aims to evaluate the effect of time to diagnosis on patient prognosis.MATERIAL AND METHODS: Retrospective cohort study of all 3613 symptomatic patients referred for esophageal cancer to our center from 1980 to 2011. Time to diagnosis was calculated as the number of days from first symptom onset to the diagnosis of esophageal cancer. The main outcome measures were: resectability and severe malnutrition at diagnosis; postoperative morbidity, mortality and survival.RESULTS: Longer time to diagnosis was significantly associated with severe malnutrition at diagnosis (odds ratio (OR): 1.003, 95{\%} confidence interval (C.I.).: 1.001-1.006) but not with resectability (OR: 0.997, 95{\%} C.I.: 0.994-1.001). Longer time to diagnosis was not associated with postoperative morbidity (OR: 1.000, 95{\%} C.I.: 0.998-1.003), postoperative mortality (OR: 1.002, 95{\%} C.I.: 0.998-1.006), five-year overall survival (hazard ratio (HR): 0.999, 95{\%} C.I.: 0.997-1.001) or five-year disease free survival (HR: 0.999, 95{\%} C.I.: 0.998-1.001).CONCLUSION: Longer time to diagnosis did not affect resectability, postoperative morbidity or survival. Further campaigns to raise awareness of cancer among population and primary health care providers may have limited effect on clinical outcome.",
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T1 - Time to diagnosis in esophageal cancer

T2 - a cohort study

AU - Cavallin, Francesco

AU - Scarpa, Marco

AU - Cagol, Matteo

AU - Alfieri, Rita

AU - Ruol, Alberto

AU - Chiarion Sileni, Vanna

AU - Rugge, Massimo

AU - Ancona, Ermanno

AU - Castoro, Carlo

PY - 2018/9

Y1 - 2018/9

N2 - BACKGROUND: The association between shorter time to diagnosis and favorable outcome is still unproven in esophageal cancer. This study aims to evaluate the effect of time to diagnosis on patient prognosis.MATERIAL AND METHODS: Retrospective cohort study of all 3613 symptomatic patients referred for esophageal cancer to our center from 1980 to 2011. Time to diagnosis was calculated as the number of days from first symptom onset to the diagnosis of esophageal cancer. The main outcome measures were: resectability and severe malnutrition at diagnosis; postoperative morbidity, mortality and survival.RESULTS: Longer time to diagnosis was significantly associated with severe malnutrition at diagnosis (odds ratio (OR): 1.003, 95% confidence interval (C.I.).: 1.001-1.006) but not with resectability (OR: 0.997, 95% C.I.: 0.994-1.001). Longer time to diagnosis was not associated with postoperative morbidity (OR: 1.000, 95% C.I.: 0.998-1.003), postoperative mortality (OR: 1.002, 95% C.I.: 0.998-1.006), five-year overall survival (hazard ratio (HR): 0.999, 95% C.I.: 0.997-1.001) or five-year disease free survival (HR: 0.999, 95% C.I.: 0.998-1.001).CONCLUSION: Longer time to diagnosis did not affect resectability, postoperative morbidity or survival. Further campaigns to raise awareness of cancer among population and primary health care providers may have limited effect on clinical outcome.

AB - BACKGROUND: The association between shorter time to diagnosis and favorable outcome is still unproven in esophageal cancer. This study aims to evaluate the effect of time to diagnosis on patient prognosis.MATERIAL AND METHODS: Retrospective cohort study of all 3613 symptomatic patients referred for esophageal cancer to our center from 1980 to 2011. Time to diagnosis was calculated as the number of days from first symptom onset to the diagnosis of esophageal cancer. The main outcome measures were: resectability and severe malnutrition at diagnosis; postoperative morbidity, mortality and survival.RESULTS: Longer time to diagnosis was significantly associated with severe malnutrition at diagnosis (odds ratio (OR): 1.003, 95% confidence interval (C.I.).: 1.001-1.006) but not with resectability (OR: 0.997, 95% C.I.: 0.994-1.001). Longer time to diagnosis was not associated with postoperative morbidity (OR: 1.000, 95% C.I.: 0.998-1.003), postoperative mortality (OR: 1.002, 95% C.I.: 0.998-1.006), five-year overall survival (hazard ratio (HR): 0.999, 95% C.I.: 0.997-1.001) or five-year disease free survival (HR: 0.999, 95% C.I.: 0.998-1.001).CONCLUSION: Longer time to diagnosis did not affect resectability, postoperative morbidity or survival. Further campaigns to raise awareness of cancer among population and primary health care providers may have limited effect on clinical outcome.

KW - Adenocarcinoma/diagnosis

KW - Aged

KW - Carcinoma, Squamous Cell/diagnosis

KW - Cohort Studies

KW - Delayed Diagnosis/statistics & numerical data

KW - Early Diagnosis

KW - Esophageal Neoplasms/diagnosis

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Time Factors

U2 - 10.1080/0284186X.2018.1457224

DO - 10.1080/0284186X.2018.1457224

M3 - Article

VL - 57

SP - 1179

EP - 1184

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0001-6381

IS - 9

ER -