胰腺癌（PDAC）的治疗时间（TTT）与生存率的关系尚不清楚。本研究评估了TTT的最新趋势、延误的原因以及对生存率的影响。我们收集了2004年至2020年期间在全国癌症数据库中接受手术或化疗/放疗（CT/RT）的所有阶段的PDAC患者。TTT被定义为组织诊断和首次治疗之间的时间间隔。线性回归（β）被用于研究时间延误的时间趋势。共纳入了239,638名患者。中位TTT为25天。多变量分析发现，年龄增长（OR 1.48）、女性性别（OR 1.04）、黑人种族（OR 1.3）、较低的教育水平（OR 1.2）、Medicaid、Medicare保险和无保险（OR 1.2、1.5和1.2）、在学术中心治疗（OR 1.3）、较高的Charlson-Deyo合并疾病指数（OR 1.2）以及CT/RT（OR 1.5）与TTT延长相关。从2004年到2020年，中位TTT从21天上升到28天（β=0.3），表明有恶化的趋势。与此同时，在早期PDAC中，新辅助CT/RT的使用趋势逐渐增加。在Cox比例风险回归分析中，TTT延误与I至IV期患者的整体生存率较差相关（HR分别为1.1、1.1、1.09和1.53）。我们观察到约10%的人口延误治疗接近2个月。TTT时间的增加趋势可能是由于早期PDAC向新辅助CT/RT的转移增加，和/或在手术前进行组织活检的使用增加。©2023年。外科肿瘤学会。

The association of time to treatment (TTT) with survival remains unclear in pancreatic adenocarcinoma (PDAC). In this study, we evaluate the recent trends in TTT, causes for delay, and its effect on survival.We included patients with PDAC of all stages from the National Cancer Database (2004-2020) who underwent either surgery or chemotherapy/radiotherapy (CT/RT). TTT was defined as the duration between tissue diagnosis and first treatment. Linear regression (β) was used to study the temporal trends in time delay.A total of 239,638 patients were included. The median TTT was 25 days. Using multivariable analysis, we found that increasing age (OR 1.48), female gender (OR 1.04), Black race (OR 1.3), lower educational status (OR 1.2), Medicaid, Medicare insurance, and uninsured (OR 1.2, 1.5, and 1.2, respectively), treatment at academic centers (OR 1.3), higher Charlson-Deyo comorbidity index (OR 1.2), and CT/RT (OR 1.5) were associated with increased TTT. There was a steady rise in median TTT from 21 to 28 days between 2004 and 2020 (β = 0.3), suggestive of a worsening trend. Concurrently, there was an increasing trend in utilization of neoadjuvant CT/RT between 2004 and 2020 in early-stage PDAC. On Cox regression, TTT delay was associated with poor overall survival in stage I-IV patients (HR 1.1, 1.1, 1.09, and 1.53, respectively).Delayed treatment approaching 2 months was observed in 10% of the population. The rising temporal trend in TTT may be attributed to the increasing shift toward neoadjuvant CT/RT in early-stage PDAC and/or the increasing use of tissue biopsy prior to surgery.© 2023. Society of Surgical Oncology.