ArticleJournal of cancer research and clinical oncology2020
Prolonged time to treatment initiation in advanced pancreatic cancer patients has no major effect on treatment outcome: a retrospective cohort study controlled for lead time bias and waiting time paradox.
Article in Journal of cancer research and clinical oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Article
- Diagnostic Timing and Ovarian Cancer Survival.JAMA network open · 2026Article
- Investigation of Treatment-Related Disparities in Metastatic Pancreatic Cancer Patients Using Real-World Data.Cancer medicine · 2025Article
- Racial/Ethnic Differences and Effects of Clinical/Socioeconomic Factors on Time from Diagnosis to Treatment in Pancreatic Cancer.Journal of gastrointestinal cancer · 2025Article
- Article
- Estimating the influencing factors for T1b/T2 gallbladder cancer on survival and surgical approaches selection.Cancer medicine · 2023Article
- Hepatopancreatobiliary malignancies: time to treatment matters.Journal of gastrointestinal oncology · 2023Article
- Survival outcomes following treatment delays among patients with early-stage female cancers: a nationwide study.Journal of translational medicine · 2022Article
- Clinical practice guidelines for the interventional treatment of advanced pancreatic cancer (5Journal of interventional medicine · 2021Article
- Acute Pancreatitis as the Initial Presentation of Pancreatic Adenocarcinoma does not Impact Short- and Long-term Outcomes of Curative Intent Surgery: A Study of the French Surgical Association.World journal of surgery · 2021Article
- Trends in Patient Volume by Hospital Type and the Association of These Trends With Time to Cancer Treatment Initiation.JAMA network open · 2021Article
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeA prolonged time to treatment initiation (TTI) correlates with an adverse prognosis in different cancer types including resectable pancreatic cancer (PC). Only limited evidence on the correlation between TTI and prognosis in advanced PC exists.
methodsConsecutive PC patients (n = 368) who were diagnosed or treated at our high-volume comprehensive cancer center were included in a prospectively maintained database. We retrospectively analyzed time from first imaging showing advanced PC to initiation of palliative first-line chemotherapy. Lead time bias and waiting time paradox were addressed by landmark analysis and correlation of tumor burden with TTI.
resultsTwo hundred and ninety-seven patients met the pre-specified in- and exclusion criteria of our study. Median TTI was 29 days (range: 1-124 days). Most common reasons for prolonged TTI (> 21 days) were referral from an external treatment center (39%) and a second biopsy (31%). A TTI above the median-, 75th or 90th percentile (43 or 60 days, respectively) had no impact on overall survival. Furthermore, no correlation between levels of carbohydrate antigen 19-9 (CA 19-9) at time of treatment initiation and TTI was observed.
conclusionWhile a timely work-up of advanced PC patients remains important, delays in treatment initiation due to repeated biopsies, inclusion in a clinical study or transfer to a specialized cancer center appear to be justified in light of the absence of a strong adverse effect of prolonged TTI on prognosis in advanced PC patients.
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