Impact of time from diagnosis to chemotherapy on prognosis in advanced pancreatic cancer

Abstract

Abstract Purpose Due to the aggressive nature and poor prognosis of advanced pancreatic cancer (PC), prompt initiation of treatment is critical. We investigated the effect of the survival time interval between cancer diagnosis and initiation of chemotherapy in patients with advanced PC. Methods In this retrospective, single-center study, consecutive patients with advanced PC between April 2013 and March 2022 were analyzed. Data were extracted from the electronic medical records of patients who received chemotherapy for metastatic, locally advanced, or resectable PC or who received chemotherapy due to either being intolerant of or declining surgery. Chemotherapy followed clinical practice guidelines. We compared overall survival between two groups: the early waiting time (WT) group (WT ≤ 30 days from diagnosis to chemotherapy initiation) and the elective WT group (WT ≥ 31 days). Prognostic factors, including biliary drainage, were considered. The impact of WT on survival was assessed by univariate and multivariate analyses with Cox proportional hazard models. A 1:1 propensity score matching (PSM) approach balanced bias, accounting for significant poor prognosis factors, age and sex. Results The study involved 137 patients. Overall survival exhibited no statistically significant difference between the early and elective WT groups (207 and 261 days, P = 0.2518). Univariate and multivariate analyses identified poor performance status and metastasis presence as predictors of worse prognosis. This finding persisted post PSM (275 and 222 days, P = 0. 8223). Conclusions Our study revealed that initiating chemotherapy within 30 days of diagnosis, as opposed to more than 30 days later, does not significantly affect treatment efficacy.