2213P - Impact of the diagnosis-to-treatment interval on the survival of patients with papillary thyroid cancer

Background

For papillary thyroid cancer (PTC) patients, no consensus has been reached for optimal diagnosis-to-treatment interval (DTI) and patient survival outcomes. In this study, we evaluated the impact of DTI on prognosis among patients with PTC.

Methods

Patients with PTC were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2019. Kaplan-Meier curves and Cox proportional hazards regression analysis were used to evaluate the impact of DTI on overall survival (OS) and thyroid cancer-specific survival (TCSS). Patients were grouped as follows: (I) 0 months (immediate treatment), (II) 1–3 months, (III) 4–5 months, and (IV) ≥6 months based on DTI.

Results

A total of 168,969 patients with PTC were included in this cohort study. Median follow-up time was 84.0 months (interquartile range [IQR], 40.0–138.0) and the median age was 49 years (IQR, 38–60). The 10-year OS rates for DTI 0, 1–3, 4–5, and ≥6 months were 90.3%, 90.1%, 84.9%, and 80.7%, respectively. By multivariable Cox proportional hazards regression analysis, there was no significant OS difference between patients with DTI 0 and DTI of 1–3 months (adjust hazard ratio [aHR] = 0.980, 95% confidence interval [CI]: 0.945–1.017). However, DTI of 4–5 months (aHR = 1.294, 95% CI: 1.166–1.435) and ≥6 months (aHR = 1.703, 95% CI: 1.504–1.928) were associated with poorer OS compared to patients with immediate treatment. Patients with treatment delay (DTI 1–3 vs. DTI 0: aHR = 1.233, 95% CI: 1.144–1.328; DTI 4–5 vs. DTI 0: aHR = 1.268, 95% CI: 1.025–1.570; and DTI ≥6 vs. DTI 0: aHR = 1.349, 95% CI: 1.031–1.766) had poorer TCSS than those receiving treatment immediately.

Conclusions

A short-term delay (1–3 months) had no significant impact on OS, whereas more than 3 months of DTI resulted in poorer OS. Any DTI delay decreased TCSS in patients with PTC. However, based on this study and the typically good prognosis for PTC, it may be safe for surveillance and treatment decision-making within 3 months after diagnosis.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.