Table 3. Morbidity-related findings of meta-analyses on the association between time to cancer diagnosis and/or treatment and clinical outcomes, by cancer site/type and lag time interval.
| Cancer | Lag time interval | Findings | First author (year) | |||||
|---|---|---|---|---|---|---|---|---|
| Site | Type | Interval | Type | Comparison | Time range | Outcome measures | Pooled risk estimate [95% CI](model type, heterogeneity statistics I2 or Ri) | |
| Blood | Smoldering multiple myeloma | T21 | Categorical | No distinct cut-off specified* | No range of lag times specified | Disease progression | HR: 0.53 [0.33–0.87] (random-effects, I2 = 86%) | Zhao et al., 2019 |
| Therapy response rate | HR: 0.87 [0.73–1.03] (fixed-effects) | |||||||
| Breast | -- | T30 | Continuous | Per 1-month increase | 31 to 203 days | LR | RR: 1.08 [1.02–1.14] (fixed-effects) | Gupta et al., 2016 |
| Colorectal | Rectal | T28 | Categorical | >4 vs. <4 weeks |
5 days to 8 weeks | pCR rate | RR: 15.71 [2.10–117.30] (fixed-effects) | Wu et al., 2018 |
| Downstaging rate | RR: 2.63 [1.77–3.90] (fixed-effects) | |||||||
| TNM stage | RR: 1.49 [1.23–1.81] (fixed-effects) | |||||||
| Sphincter-preserving rate | RR: 1.05 [0.96–1.15] (fixed-effects) | |||||||
| R0 resection rate | RR: 1.08 [0.99–1.19] (fixed-effects) | |||||||
| Incidence of postoperative complications | RR: 0.81 [0.70–0.95] (fixed-effects) | |||||||
| Rectal | T29 | Categorical | >7–8 vs. <7–8 weeks |
5 to >12 weeks | pCR rate | RR: 1.45 [1.18–1.78] (fixed-effects) | Wang et al., 2016 | |
| Categorical | >6–8 vs. <6–8 weeks |
4 to 14 weeks | pCR rate | RR: 1.42 [1.19–1.68] (fixed-effects) | Petrelli et al., 2016 | |||
| Categorical | ≥8 vs. <8 weeks |
4 to 14 weeks | pCR rate | RR: 1.24 [1.14–1.35] (random-effects, I2 = 9.8%) | Du et al., 2018 | |||
| Operative time | SMD: 0.15 [0.03–0.32] (random-effects, I2 = 24.3%) | |||||||
| Incidence of LR | RR: 0.92 [0.61–1.37] (random-effects, I2 = 65.1%) | |||||||
| Postoperative complications | RR: 0.95 [0.83–1.09] (random-effects, I2 = 25.6%) | |||||||
| Anastomotic leakage | RR: 0.89 [0.49–1.63] (random-effects, I2 = 0%) | |||||||
| Sphincter-preserving surgery | RR: 0.99 [0.91–1.07] (random-effects, I2 = 0%) | |||||||
| Head and neck | Oral | T1 | Categorical | No distinct cut-off specified | >30 days to >1 month | TNM staging | RR: 1.55 [1.14–2.12] (fixed-effects) | Seoane et al., 2016 |
| RR: 1.55 [1.14–2.12] (random-effects, Ri = 0.00) | ||||||||
| T11 | Categorical | No distinct cut-off specified | >30 days to >1 month | TNM staging | RR: 1.83, [1.31–2.56] (fixed-effects) | |||
| RR: 2.15 [1.08–4.29] (random-effects, Ri = 0.74) | ||||||||
| T1, T2, T4, T11 | Categorical | No distinct cut-off specified | >30 to >45 days | TNM staging | RR: 1.61 [1.33–1.93] (fixed-effects) | |||
| RR: 1.66 [1.25–2.20] (random-effects, Ri = 0.49) | ||||||||
| Oropharyngeal, Oral (advanced stage) | T4 | Categorical | No distinct cut-off specified | No range of lag times specified | TNM staging | OR: 1.32 [1.07–1.62] (fixed-effects) | Gómez et al., 2009 | |
| OR: 1.25 [0.84–1.85] (random-effects, Ri = 0.70) | ||||||||
| Esophageal | T29 | Categorical | >7–8 vs. ≤7–8 weeks |
≤46 to >64 days | pCR rate | OR: 0.97 [0.73–1.30] (fixed-effects) | Lin et al., 2016 | |
| Postoperative mortality | OR: 0.75 [0.40–1.44] (fixed-effects) | |||||||
| Anastomotic leakage | OR: 1.33 [0.69–1.85] (fixed-effects) | |||||||
| R0 resection rate | OR: 1.71 [1.14–2.22] (fixed-effects) | |||||||
Significant pooled risk estimates are bolded.
-- indicates that cancer type not specified or applicable to the site.
*
Meta-analysis utilized the ‘early’ and ‘late’ lag time interval definitions in included studies without standardization of lag time cut-offs.
CI, confidence interval; HR, hazard ratio; LR, local recurrence; OR, odds ratio; pCR, pathological complete response; RR, risk ratio; SMD, standard mean difference.