手术延误对乳头状甲状腺癌（PTC）患者的生存影响不明确。我们旨在研究手术时间和患者生存之间的关联。在1999-2018年SEER-Medicare链接数据文件中，共鉴定出8,170名接受甲状腺切除术的PTC患者。应用Kaplan-Meir分析估计疾病特异性生存（DSS）和总生存（OS），应用Cox比例风险模型估计手术时间与生存之间的关联。在8,170名PTC患者中，平均年龄69.3岁（标准差+/-11.4），89.8%的患者在诊断后的前90天进行手术，7.8%的患者在诊断后91-180天进行手术，而2.4%的患者在180天后才进行手术。手术时间的增加与>180天组的OS死亡率增加有关（aHR 1.24，95% CI 1.01-1.53）。另外，在总体分期方面，91-180天组局部疾病的患者OS死亡风险增加了25%（aHR 1.25 95%CI 1.05-1.51），而超过180天的拖延则增加了61%的风险（aHR 1.61 95%CI 1.19-2.18）。 >180天组中的局部疾病患者DSS死亡率的估计率几乎是四倍（aHR 3.51 95%CI 1.68-7.32）。根据T分期进行分层时，>180天组中T2疾病的患者所有原因的死亡率的估计值是两倍（aHR 2.0，95% CI 1.1-3.3），而疾病特异性死亡率的估计值几乎是三倍（aHR 2.7，95% CI 1.05-6.8）。PTC的手术延迟可能会影响局部疾病的OS和DSS，在淋巴结转移之前。©2023作者。由牛津大学出版社代表内分泌学会出版。保留所有权利。有关权限，请发送电子邮件至：journals.permissions@oup.com。

Delays in surgery and their impact on survival in papillary thyroid cancer (PTC) is unclear. We sought to investigate the association between time to surgery and survival in patients with PTC.A total of 8,170 Medicare beneficiaries with PTC who underwent thyroidectomy were identified within the SEER-Medicare linked data files between 1999-2018. Disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meir analysis, and Cox proportional hazards models were specified to estimate the association between time to surgery and survival.Among 8,170 patients with PTC, mean age 69.3 (SD+/- 11.4), 89.8% had surgery within the first 90 days, 7.8% had surgery 91-180 days from diagnosis, and 2.4% had surgery after 180 days. Increasing time to surgery was associated with increased mortality for OS in the >180-day group (aHR 1.24, 95% CI 1.01-1.53). Moreover, on stratification by summary stage, those with localized disease in the 91-180-day group increased risk by 25% (aHR 1.25 95%CI 1.05-1.51) and delaying over 180 days increased risk by 61% (aHR 1.61 95%CI 1.19-2.18) in OS. Those with localized disease in the >180-day group had almost four times the estimated rate of DSS mortality (aHR3.51 95%CI 1.68-7.32). When stratified by T stage, those with T2 disease in the >180 days group had double the estimated rate of all-cause mortality (aHR 2.0, 95% CI 1.1-3.3) and almost triple the estimated rate of disease-specific mortality (aHR 2.7, 95% CI 1.05-6.8).Delays in surgery for PTC may impact OS and DSS in localized disease, prior to nodal metastasis.© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.