title: Effect of treatment delay on survival in patients with cervical cancer: a historical cohort study.
abstract: OBJECTIVE
  The objective of this study was to evaluate the effect of treatment delay on prognosis in patients with cervical cancer.
  
  
  METHODS
  The study group of this historic cohort study comprised 321 patients newly diagnosed with cervical cancer between 1999 and 2010. Time from diagnosis to treatment was analyzed both as a continuous variable and as a categorical variable in 3 groups that differed in waiting time between diagnosis and treatment initiation: 30 days or less (group 1, n = 134), 30 to 45 days (group 2, n = 86), and more than 45 days (group 3, n = 101). Associations between waiting time group, patients' characteristics, and disease outcome were investigated using t tests, analyses of variance and Cox regression analyses, Kaplan-Meier survival analysis, and log-rank (Mantel-Cox) tests.
  
  
  RESULTS
  Time from diagnosis to treatment initiation, when analyzed as a continuous variable, was not a significant factor in survival. There were no between-group differences in age, smoking rate, marital status, gravidity, parity, tumor histology, or lymph node involvement. Early-stage disease and small tumor diameter were diagnosed most frequently in group 3. However, there was no significant between-group difference in 3-year survival rates (74.6%, 82.2%, and 80.8% in groups 1, 2, and 3, respectively; P = 0.38). On multivariate analysis, only stage, histology, and lymph node involvement were significant prognostic factors for survival. Before starting treatment, 28 patients underwent ovarian preservation procedures.
  
  
  CONCLUSIONS
  Longer waiting time from diagnosis to treatment was not associated with worse survival. Our findings imply that if patients desire fertility or ovarian preservation procedures before starting treatment, it is acceptable to allow time for them.
authors: *Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, and †Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, and ‡Division of Oncology, Sheba Medical Center, Tel Hashomer, Israel.
authors: Tamar
authors: T
authors: Perri
authors: Gal
authors: G
authors: Issakov
authors: Gilad
authors: G
authors: Ben-Baruch
authors: Shira
authors: S
authors: Felder
authors: Mario E
authors: ME
authors: Beiner
authors: Limor
authors: L
authors: Helpman
authors: Liat
authors: L
authors: Hogen
authors: Ariella
authors: A
authors: Jakobson-Setton
authors: Jacob
authors: J
authors: Korach
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D005260:Female; D065386:Historically Controlled Study; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D016019:Survival Analysis; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D014850:Waiting Lists / Q000401:mortality