Treatment delays in XXXX and their prognostic implications.

@entity1 @entity1149
INTRODUCTION: The impact of treatment delays on survival of @entity1 with @entity1149 ( @entity1149 ) is uncertain. Although later treatment could negatively affect psychological well-being, the maximum acceptable waiting time has not been determined. METHODS: We analyzed consecutive @entity1 with @entity1149 between January 2005 and May 2007 in our center. Treatment delay was calculated from the first abnormal radiographic study. Cox proportional hazards analysis was used to identify predictive factors and log-rank tests to compare survival. RESULTS: Four hundred ninety-five cases were identified; shorter treatment delays were associated with a poor prognosis. Conversely, for every week that the treatment could be delayed, the hazard ratio was improved at 0.97 (p = 0.05). Standard treatment was given to 319 of these @entity1 who were separated in localized, regional, and advanced stages. The median treatment delay was 73 days and distributed as follows: 85, 94, and 50 days for localized, regional, and advanced stages, respectively (p < 0.01). For localized or regional stages, the association between treatment delay and survival was inconclusive. In the advanced group, each week of treatment delay had a hazard ratio of 0.93 (p = 0.009). Survival of advanced @entity1 who began treatment earlier versus later than the group median was 6.8 versus 11.6 months (p = 0.027). CONCLUSIONS: For @entity1 with advanced @entity1149 receiving equivalent chemotherapy regimens, shorter treatment delays were associated with shorter survival. We hypothesize that urgent treatment carried a negative prognostic meaning, as this was preferentially offered to @entity1 presenting with a higher symptom burden, which conferred them a worse outcome.
