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Demystifying delays: Factors associated with timely treatment of adrenocortical carcinoma
Jesse E Passman1, Julia A Gasior2, Sara P Ginzberg1
1Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA.
Background:
Delays in management of adrenocortical carcinoma (ACC) may lead to worse outcomes. We assessed for delays in ACC treatment according to sociodemographic factors.
Methods:
We performed a retrospective cohort study of patients treated for ACC (2010-2019) utilizing the National Cancer Database. Cox proportional hazards modeling was used to evaluate the associations between sociodemographic, geographic, and clinical factors and time to intervention from diagnosis.
Results:
Across 1399 subjects treated for ACC, the median time to treatment was 27 days (IQR 15-47). Non-Hispanic Black patients (HR 0.798, p = 0.033) and patients aged 40-64 years (HR 0.800, p = 0.008) were at greater risk of delays in care, whereas female patients (HR 1.169, p = 0.011) and those with metastatic disease (HR 1.176, p = 0.010) received more timely care.
Conclusions:
Older age, male sex, and Black race were associated with delays in care for ACC though these delays did not translate to worsened overall survival.
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