Su1790 Excision and Revision of Ileal Pouch-Anal Anastomosis: Insights From 308 NSQIP Cases

Abstract

(p<0.0001). Significant factors associated with treatment delay time ≥ 6 weeks were older age (40-49 years, 10.6%, compared with 70-79 years, 15.6%), African American race (African American, 22.2% compared with non-Hispanic White, 14.5%), low SES (lowest SES, 19.1%, compared with highest SES, 13.0%), stage I cancer (stage I, 22.2% compared with stage II and III, 12.3% and 13.4%, respectively), and left-sided cancer (left-sided cancer, 18.1% compared with right-sided cancer, 13.6%). Impact of treatment delay on cancer-specific mortality was most pronounced in stage II cancers (delay 6-12 weeks, HR 1.30, p=0.0171 and delay ≥ 12 weeks, HR 1.99, p=0.0002) and T4 tumors (delay 6-12 weeks, HR 1.35, p=0.0027 and delay ≥ 12 weeks, HR 1.42, p=0.0298). Conclusions: Delays of 6 weeks or longer in definitive surgical treatment of colon cancer after diagnosis are associated with increasedmortality. It is unclear whether this reflects neoplastic progression or other unrecognized factors associated with delay. Until this is clarified, it may be advisable to encourage patients with colon cancer to initiate surgical treatment without significant delay.