Background/Objectives: Ovarian and endometrial cancers present significant health burdens due to their substantial morbidity and mortality. Surgery delay is hypothesized to negatively impact patient outcomes, yet evidence remains inconsistent. This systematic review aims to comprehensively evaluate current evidence regarding the effects of treatment delay on survival and quality of life in these patients. Methods: A systematic literature search was conducted in MEDLINE (PubMed), Cochrane Library, Scopus, and ClinicalTrials.gov databases, complemented by a manual screening of reference lists, with studies included up to March 2025. Two independent reviewers screened and assessed the methodological quality using the ROBINS-E tool and extracted the data from the studies. Due to substantial methodological and clinical heterogeneity, results were synthesized qualitatively through narrative synthesis. Results: Twenty-one studies met the inclusion criteria, comprising predominantly retrospective cohort analyses. Treatment delays consistently correlated with decreased survival and advanced disease stages. Among studies, optimal intervals from diagnosis to treatment were varied from 2 to 8 weeks. Patient-reported outcomes indicated heightened anxiety, increased distress, and poor satisfaction with prolonged delays. Healthcare system factors such as resource allocation, geographic disparities, and socioeconomic inequalities significantly contributed to delays. Quantitative survival metrics supported a clear negative association between treatment delays and survival, although paradoxical outcomes in select subgroups highlighted underlying complexities. Conclusions: This systematic review underscores the critical importance of minimizing delays in the treatment of ovarian and endometrial cancers to improve patient survival and psychological outcomes. Identified healthcare system barriers demand targeted policy interventions to ensure timely and equitable access to tertiary healthcare infrastructures. Future research should prioritize standardizing delay definitions to strengthen and homogenize evidence.
背景/目的：卵巢癌和子宫内膜癌因其高发病率与死亡率构成重大健康负担。手术延迟被推测会对患者预后产生负面影响，但现有证据尚不一致。本系统综述旨在全面评估当前关于治疗延迟对这两类患者生存及生活质量影响的证据。方法：在MEDLINE（PubMed）、Cochrane Library、Scopus及ClinicalTrials.gov数据库进行系统性文献检索，并辅以参考文献列表的人工筛查，纳入截至2025年3月的研究。由两名独立评审员使用ROBINS-E工具进行筛选和方法学质量评估，并提取研究数据。由于存在显著的方法学与临床异质性，结果通过叙述性综合进行定性整合。结果：共21项研究符合纳入标准，主要为回顾性队列分析。治疗延迟与生存率下降及疾病分期进展呈持续相关性。各研究提出的从诊断到治疗的最佳时间窗在2至8周之间不等。患者报告结局显示，延迟时间延长会导致焦虑加剧、痛苦增加及满意度下降。医疗系统因素（如资源配置、地域差异和社会经济不平等）是造成延迟的重要原因。定量生存指标支持治疗延迟与生存率存在明确负相关，但特定亚组中出现的矛盾结果揭示了潜在的复杂性。结论：本系统综述强调，最大限度减少卵巢癌和子宫内膜癌的治疗延迟对改善患者生存及心理结局至关重要。已识别的医疗系统障碍需要针对性政策干预，以确保患者能及时、公平地获得三级医疗资源。未来研究应优先推进延迟定义的标准化，以增强证据强度并提升证据同质性。
The Impact of Treatment Delay on Endometrial and Ovarian Cancer Patients: A Systematic Review
肿瘤(癌症)患者之家