Impact of time from diagnosis to endoscopic resection on clinical outcomes in early gastric cancer

This retrospective cohort evaluated whether delays up to 180 days impair oncological and pathological outcomes.</p> <p>We enrolled 1646 consecutive EGC patients who underwent curative ER between 2010 and 2023. Primary endpoints were overall survival (OS) and disease-free survival (DFS); secondary endpoints included positive resection margins, pathological upstaging, curative resection rate, and additional gastrectomy requirement.

Analyses comprised Kaplan–Meier curves, multivariable Cox/logistic regression with time modeled categorically (<30 vs. ≥30 days) and continuously (per 10-day increment), plus restricted cubic spline (RCS) modeling. Sensitivity analysis was conducted after excluding high risk deep submucosal (SM2) lesions.</p> <p>Median waiting time was 15 days (IQR 11–23); only 2.3% waited >90 days. Linear and RCS analyses showed no independent adverse associations between delays within 180 days and any primary or secondary endpoint (all p > 0.05).