For women with early-stage cervical cancer, postponement of surgery to 8 weeks after diagnosis did not appear to be associated with worse short-term clinical outcomes, supporting the suggestion by an expert panel that hysterectomy be postponed for 6 to 8 weeks for this patient population living in novel coronavirus (COVID-19) hotspot areas.1
Recently reported in Gynecologic Oncology, the single institution retrospective observational study included 217 women with early-stage cervical cancer who underwent primary hysterectomy or trachelectomy at the Los Angeles County Medical Center between 2000 and 2017.
Women were grouped by length of time between diagnosis via biopsy and surgery. Shorter than 8 weeks between diagnosis and surgery was considered a short wait time (110 women) and 8 weeks or longer between surgery was considered a long wait time (107 women).
At a median follow-up of 4.6 years, the disease-free survival (DFS) was similar between the long wait-time group and short wait-time group (91.2% vs 90.7%; hazard ratio [HR], 1.11; 95% CI, 0.47–2.59; P =.818), according to a weighted model. The overall survival (OS) was also similar between the long wait-time group and short wait-time group (95.0% vs 97.4%; HR, 1.47; 95% CI, 0.50–4.31; P =.487).
The study authors also did a meta-analysis of 3 studies, one of which was the current study. A pooled analysis showed that a long wait time had an HR of 0.96 (95% CI, 0.59–1.55) for DFS and 1.29 (95% CI, 0.37–4.48) for OS. The “wide range” for the OS confidence interval “dilutes the interpretation of results, necessitating further studies to examine this association,” the study authors wrote.
The study authors cautioned that while their findings “partly” support the expert panel’s suggestion to consider postponement of surgery, “further studies with a larger sample size are warranted to examine the effect of long wait time on survival in stage IB-IIA cervical cancer, particularly for tumor size >2 cm.”
Matsuo K, Novatta H, Matsuzakia S, et al. Wait-time for hysterectomy and survival of women with early-stage cervical cancer: A clinical implication during the coronavirus pandemic [published online May 18, 2020]. Gynecol Oncol. doi: 10.1016/j.ygyno.2020.05.019