Patient and physician treatment delay in patients with stomach cancer in Norway: is it important? The Norwegian Stomach Cancer Trial.
The effect and consequences of treatment delay were studied in 1165 patients with stomach cancer included in a Norwegian multicentre study. Median patient delay was 42 days; median doctor delay 37 days; and median total treatment delay 107 days. By Cox proportional hazards model analyses we found that an increase in weight loss was associated with an increase in total delay, whereas a more advanced stage of disease was related to a short total delay. Physician delay was more pronounced in women, increased with increasing Karnofsky performance index, but decreased in patients with stage-IV disease. By logistic regression analyses we found no association between delays and postoperative complication rate. The relationship between physician delay and postoperative mortality was statistical significant, with increasing number of deaths with decreasing delay. In conclusion, there is no evidence that long treatment delay is an important negative factor in relation to outcome of surgery.