Time from diagnosis to treatment affects survival of patients with squamous cell carcinoma

In patients with nonmetastatic anal squamous cell carcinoma, time from diagnosis to treatment initiation longer than 2 months appears to result in poorer survival outcomes, a study has found.

A group of researchers probed the Surveillance, Epidemiology, and End Results research plus database to identify and review patients with nonmetastatic anal squamous cell carcinoma. They assessed the factors associated with longer time to treatment using multivariable logistic regression analysis.

Additionally, the researchers examined survival differences according to time to treatment (≤2 vs >2 months) using Kaplan-Meier survival estimates and assessed the factors associated with worse overall and cancer-specific survival using multivariable Cox regression analysis.

A total of 13,032 patients met the eligibility criteria of the study. Factors associated with longer time to treatment (>2 months) were male sex (odds ratio [OR], 1.503, 95 percent confidence interval [CI], 1.292‒.749) and non-White race (OR for Black vs White patients, 1.846, 95 percent CI, 1.488‒2.290; OR for American Indian vs White patients, 2.414, 95 percent CI, 1.197‒4.872; OR for Asian-Pacific Islanders vs White patients, 2.182, 95 percent CI, 1.440‒3.309).

Kaplan-Meier survival estimates showed the association of longer time to treatment with worse overall survival (median overall survival for >2 months, 109 months; for ≤2 months, 164 months; p<0.0001).

Multivariate analysis revealed worse overall survival to be significantly correlated with older age (hazard ratio [HR], 1.037, 95 percent CI, 1.034‒1.039), male sex (HR, 1.650, 95 percent CI, 1.548‒1.758), Black race (HR, 1.341, 95 percent CI, 1.1210‒1.487), advanced stage (HR, for regional vs localized stage, 1.596, 95 percent CI, 1.500‒1.698), and longer time to treatment (HR, 1.385, 95 percent CI, 1.222‒1.571).