The impact of wait times on oncological outcome in high-risk patients with endometrial cancer

Objective: To evaluate the impact of surgical wait times on outcome of patients with grade 3 endometrial cancer. Methods: All consecutive patients surgically treated for grade 3 endometrial cancer between 2007 and 2015 were included. Patients were divided into two groups based on the time interval between endometrial biopsy and surgery: wait time from biopsy to surgery ≤12 weeks (84 days) vs more than 12 weeks. Survival analyses were conducted using log-rank tests and Cox proportional hazards models. Results: A total of 136 patients with grade 3 endometrial cancer were followed for a median of 5.6 years. Fifty-one women (37.5%) waited more than 12 weeks for surgery. Prolonged surgical wait times were not associated with advanced stage at surgery, positive lymph nodes, increased lymphovascular space invasion, and tumor size (P =.8, P = 1.0, P =.2, P =.9, respectively). In multivariable analysis adjusted for clinical and pathological factors, wait times did not significantly affect disease-specific survival (adjusted hazard ratio [HR]: 1.2, 95% confidence interval [CI], 0.6-2.5, P =.6), overall survival (HR: 1.1, 95% CI, 0.6-2.1, P =.7), or progression-free survival (HR: 0.9, 95% CI, 0.5-1.7, P =.8). Conclusion: Prolonged surgical wait time for poorly differentiated endometrial cancer seemed to have a limited impact on clinical outcomes compared to biological factors.