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Influence of Diagnostic and Treatment Delays on Survival Outcomes in Patients With Locally Advanced Rectal Cancer: A
Yutian Zhao1, Jiahao Zhu1, Benjie Xu2
1Department of Radiotherapy and Oncology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People's Republic of China.
Objective:
To investigate the impact of diagnostic and treatment delays on the prognosis of patients with locally advanced rectal cancer (LARC).
Methods:
Retrospective analyses were performed in Chinese and American cohorts. The intervals from symptom onset to diagnosis and from diagnosis to initial treatment were defined as diagnostic and treatment delays. A univariate and multivariable Cox regression model was conducted for overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS).
Results:
A total of 450 Chinese and 5810 American patients were included in this study. Multivariable analysis revealed that a prolonged diagnostic delay (> 5 months) was significantly associated with decreased OS (hazard ratio [HR]: 1.50, p = 0.041) and DFS (HR: 1.36, p = 0.047). Additionally, an extended treatment delay (> 2 months) was closely associated with reduced OS (> 1 and ≤ 2 months vs. ≤ 1 month, HR: 1.06, p = 0.386; > 2 months vs. ≤ 1 month, HR: 1.52, p < 0.001) and CSS (> 1 and ≤ 2 months vs. ≤ 1 month, HR: 1.03, p = 0.693; > 2 months vs. ≤ 1 month, HR: 1.58, p = 0.001) in patients with LARC.
Conclusion:
Diagnostic intervals exceeding 5 months and treatment delays of more than 2 months are significantly associated with unfavorable survival outcomes in LARC patients. These findings underscore the importance of timely diagnostic pathways and treatment initiation and may serve as clinically meaningful benchmarks for healthcare systems to optimize referral processes, resource allocation, and quality-of-care assessment in rectal cancer management.
