Waiting time to surgery and pancreatic cancer survival: A nationwide population-based cohort study

Introduction: The effect of waiting time to surgery on survival in pancreatic cancer patients is unclear. We examined this association in a nationwide population-based cohort study. Materials and methods: A nationwide population-based cohort study of all patients undergoing surgery for pancreatic cancer (resection or a palliative procedure) registered in the Danish Pancreatic Cancer Database from May 2011 to May 2016. We defined waiting time to surgery in two ways: 1) from the date of entry into the National Cancer Pathway to the date of surgery and 2) from the date of the last preoperative computed tomography (CT) or positron emission tomography (PET-CT) scan to the date of surgery. Waiting time was grouped into three groups: <28 days (<4 weeks), 28–55 days (4–8 weeks), and ≥56 days (≥8 weeks). We calculated median survival with associated 95% confidence intervals (CIs) for patients undergoing resection and for patients undergoing a palliative procedure. Results: We included 873 patients. Mean age was 67 years (range: 35–86 years). Resection was performed in 701 patients (80%); the remaining 172 patients (20%) underwent an explorative laparotomy or palliative surgery. 652 patients (75%) had a registration in the National Cancer Pathway (median waiting time: 31 days, and 818 patients (94%) had registration of a preoperative CT or PET-CT scan (median waiting time: 32 days). We saw similar resection rates (∼80%) and median survival (∼22 months) in all thee groups. Conclusion: In this study, waiting time to surgery did not affect survival in patients undergoing surgery for pancreatic cancer.