ArticleJournal of gynecologic oncology2026
Impact of the diagnosis-surgery interval on survival outcomes and development of a nomogram for predicting survival in early-stage cervical cancer: a Surveillance, Epidemiology, and End Results database analysis.
Article in Journal of gynecologic oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveWe evaluated the association between the diagnosis-surgery interval on survival in early-stage cervical cancer (CC) and developed a nomogram for survival prediction.
methodsWe analyzed Surveillance, Epidemiology, and End Results data (2000-2019) of 7,827 patients with stage I-II CC who underwent radical or extended hysterectomy as primary treatment. Associations among the diagnosis-surgery interval, prognostic factors, overall survival (OS), and cancer-specific survival (CSS) were examined. A nomogram constructed using a multivariate Cox model was assessed using the concordance index (C-index) and a calibration curve.
resultsMost patients had stage I (95.15%) squamous cell carcinoma (62.21%), tumor size ≤2 cm (39.86%), without lymph node (LN) involvement (86.07%). Adjuvant radiation and chemotherapy were administered to 28.03% and 18.72% of the patients, respectively. The median diagnosis-surgery interval was 1 month (range: 0-17 months). Older age, non-Hispanic black race, higher stage, higher grade, larger tumor size, LN involvement, adjuvant radiation, and surgical delay (>1 month) were associated with worse OS and CSS (p=0.009 and p=0.022, respectively). Adenosquamous carcinoma was associated with poor CSS. The nomogram predicted survival, with areas under the curve of 76.07% and 80.19% for 5-year OS and CSS, respectively. Calibration curves and C-index values (0.735 for OS and 0.777 for CSS) confirmed the nomogram's accuracy in predicting 3-, 5-, and 10-year OS and CSS in early-stage CC.
conclusionSurgical delays of >1 month were associated with worse survival in early-stage CC. The developed nomogram incorporates multiple prognostic factors to enhance personalized risk assessment and survival prediction.
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