title: Impact of wait times on survival for women with uterine cancer.
abstract: OBJECTIVE
  To determine whether wait time from histologic diagnosis of uterine cancer to time of definitive surgery by hysterectomy had an impact on all-cause survival.
  
  
  METHODS
  Women in Ontario with a confirmed histopathologic diagnosis of uterine cancer between April 1, 2000, and March 31, 2009, followed by surgery were identified in the Ontario Cancer Registry. Survival was calculated by using the Kaplan-Meier method. Factors were evaluated for their prognostic effect on survival by using Cox proportional hazards regression. Wait time was evaluated in a multivariable model after adjusting for other significant factors.
  
  
  RESULTS
  The final study population included 9,417 women; 51.9% had surgery by a gynecologist, and 69.9% had endometrioid adenocarcinoma. Five-year survival for women with wait times of 0.1 to 2, 2.1 to 6, 6.1 to 12, or more than 12 weeks was 71.1%, 81.8%, 79.5%, and 71.9%, respectively. Wait times of ≤ 2 weeks were adversely prognostic for survival after adjusting for other significant factors in the multivariable model, and patients with wait times of more than 12 weeks had worse survival than those who had wait times between 2.1 and 12.0 weeks.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first report in a large population-based cohort demonstrating that longer wait times from diagnosis of uterine cancer to definitive surgery have a negative impact on overall survival.
authors.affiliation: All authors: Escarpment Cancer Research Institute, McMaster University, Hamilton, ON, Canada.
authors.forename: Lorraine M
authors.initials: LM
authors.lastname: Elit
authors.forename: Erin M
authors.initials: EM
authors.lastname: O'Leary
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Pond
authors.forename: Hsien-Yeang
authors.initials: HY
authors.lastname: Seow
mesh_terms: D000328:Adult; D000368:Aged; D018269:Carcinoma, Endometrioid / Q000175:diagnosis / Q000191:economics / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000191:economics; D019458:Insurance Coverage; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario / Q000453:epidemiology; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D061665:Time-to-Treatment; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000191:economics / Q000401:mortality* / Q000601:surgery; D014850:Waiting Lists